PHARMAC to fund new diabetes medicines with amended Special Authority criteria
PHARMAC has approved funding for two new medicines with substantial health benefits for around 53,000 New Zealanders with type 2 diabetes.
People with high-risk type 2 diabetes, who meet the funding criteria, will be able to access funded empagliflozin (with or without metformin) from 1 February 2021. They will also be able to get funded dulaglutide once it has Medsafe approval.
“People with diabetes, their whānau and health professionals told us that there is a need for these effective medicines to be funded to help manage the growing health problem of type 2 diabetes in Aotearoa,” says PHARMAC’s chief executive Sarah Fitt.
Evidence suggests these medicines do more than just reduce sugar levels in people with high-risk type 2 diabetes. They can also help manage type 2 diabetes-related complications like kidney and heart disease in people who are at high risk of these complications.
“We had originally proposed to fund empagliflozin (with and without metformin) from 1 December 2020, however we received a substantial amount of consultation feedback that took us some time to work through. After carefully considering the consultation feedback we made some changes to the Special Authority criteria we originally proposed.”
The changes to the criteria aim to make sure that people with type 2 diabetes who are at a high risk of heart and kidney complications can access these treatments.
“We have also made the decision to specifically name Māori and Pacific ethnicities within the funding criteria. This is the first time we have included this wording in Special Authority criteria. This is an intentional move to proactively promote equity of access to these treatments for population groups who are at high risk of complications of type 2 diabetes and for whom there is direct evidence of inequities in access to medicines. We would like to thank the people and organisations who contributed important feedback that supported this decision,” says Ms Fitt.
“We know that funding medicines does not in itself address many of the barriers to access that people face. There are lots of structural issues in the health system that PHARMAC cannot address by itself with this funding decision. We acknowledge that health inequities are unable to be addressed by medicines alone, and that these medicines are focussed on treatment, rather than prevention but we also know that PHARMAC does have a role to play.
PHARMAC is committed to continuing our work to fund more medicines for more people, delivering the best possible health outcomes for New Zealanders from within our fixed budget. The gross cost to the combined pharmaceutical budget for these two medicines is estimated to be roughly $125 million over 5 years.