Summary of decision: mepolizumab for relapsed or refractory EPGA

How we've come to this decision

Pharmac has reached an agreement with the supplier, GSK, to fund three treatments and widen access to another treatment and a vaccine. As part of this agreement there are contractual changes to other medicines.

As Pharmac works within a fixed budget, negotiations like these with suppliers help us make more medicines available to more New Zealanders. 

Mepolizumab for EPGA

Mepolizumab is currently funded for people with severe eosinophilic asthma. 

Access to mepolizumab (branded as Nucala) will be widened to include people with relapsed or refractory eosinophilic granulomatosis with polyangiitis (EGPA). EPGA was formerly called Churg-Strauss syndrome and it is a rare disorder. 

EPGA is a form of vasculitis, causing severe swelling of blood vessels, often affecting the heart or kidneys. The treatment will reduce the risk of organ damage, improve symptoms and the patient’s survival. 

We expect up to 15 people in New Zealand would receive mepolizumab for EGPA in the first year of funding. 

What we heard during the consultation

We’ve made some changes to the eligibility criteria to make it easier for people to access mepolizumab if they cannot tolerate other funded treatments. We have made a change to the funding criteria to clarify that people would need to trial one of the other funded treatments for at least three months, but that this would not need to occur at the maximum tolerated dose.

What we will explore in the future

We understand some people may not be able to trial other funded treatments as the eligibility criteria requires. We would be happy to consider a Special Authority waiver for someone who meets the intent of the criteria, but is unable to trial funded alternatives for three months due to intolerance.

In the future we will seek advice from our Respiratory Advisory Committee about removing the requirement to trial other funded treatments before receiving mepolizumab. Another application would support this, so we can assess this widening of access through our usual funding process.