Questions and Answers on budget increase

The Government is giving Pharmac an additional $604 million over 4 years to fund or widen access to many more medicines, including cancer medicines. Pharmac and Health New Zealand will also receive funding for implementation costs over that period.

As of now, Pharmac estimates that the additional funding will cover approximately:

• 26 cancer medicines for a number of cancer types, including thyroid, bowel, breast, bladder, lung, head and neck, prostate, liver, ovarian, kidney and four different blood cancers. This includes treatments covering all of the cancer types covered by the list of 13 cancer treatments proposed previously plus other types not previously included (such as blood cancers).
• 28 other medicines that will include medicines for a wide range of conditions including infections, respiratory conditions, osteoporosis, sexual health, dermatology, inflammatory conditions, and mental health.

This list is subject to change as new medicines are being developed all of the time and Pharmac considers the best available clinical evidence when assessing medicines for funding.

Of the 13 cancer treatments identified in 2023, up to 7 will be included and the remaining 6 will be replaced by alternatives as good or better.  That means there will be medicines funded for each of the cancer groups in the original list. However, it is too soon to identify the specific medicines that will be available to treat these cancer groups.

Pharmac needs to go through its usual robust, open and fair processes, negotiating with suppliers, and consulting the public, particularly clinicians and people living with health conditions. That means Pharmac is not yet in a position to name the specific medicines that will be available. We will share this information with you as soon as we can, as we know that people with cancer and their clinicians will want to work through the eligibility criteria to access these medicines. 

The team at Pharmac is ready to start work immediately to get these medicines to the people who need them as soon as possible. As part of our usual process, we do a lot of work behind the scenes so that when funding becomes available to us, we are able to work at pace and coordinate with Health New Zealand and other key stakeholders so that patients can benefit. 

At the time funding was announced, Pharmac estimates about 175,000 people will be eligible for treatment in in the first full year of funding of each medicine. The exact number of people to benefit will depend on the specific medicines Pharmac decides to fund.

The team is currently working on a large number of proposals simultaneously, including those on the Options for Investment (OFI) and proposals arising from other processes. 

The sequencing of consultation and implementation of these proposals is impacted by the time needed to conduct necessary negotiations (including running a competitive process if there are multiple potential suppliers), supplier lead times and sector readiness to deliver (among other factors). This means the timings won’t always match the OFI order of the proposals. 

Given the number of steps involved, the earliest some of the new medicines are likely to start being funded will be October or November this year. 

From application to funded medicine: Pharmac's process

We will obviously need to talk with suppliers to make sure they can provide the medicines we need, in the amounts needed and when we want them to be available. Pharmac already has strong relationships with many suppliers from the work we already do with this, and we will be able to get these discussions with suppliers started right away. 

Pharmac also wants to hear from people living with health conditions, clinicians, consumer advocacy groups and clinical organisations, as well as our health sector partners.