Funding data for ustekinumab via the Exceptional Circumstances Framework

1 October 2020

Dear [name and contact details redacted]

REQUEST FOR INFORMATION

Thank you for your request dated 16 September 2020 under the Official Information Act 1982 (OIA) for information relating to Named Patient Pharmaceutical Assessment (NPPA) applications for ustekinumab. You requested:

• Can Pharmac please advise whether others are being rejected for funding of this drug on compassionate grounds, or how many applications they have received about ustekinumab?

The Exceptional Circumstances Framework (Framework) outlines the ways in which PHARMAC generally considers funding decisions for exceptional circumstances that fall outside of the Pharmaceutical Schedule funding process, and guides PHARMAC’s decision making in these cases. This Framework includes the Named Patient Pharmaceutical Assessment (NPPA) Policy and other processes through which PHARMAC considers exceptional circumstances. In order to make a decision for a NPPA application, we need to know how the patient’s circumstances differ from the wider patient population.

Please refer to our webpage Making a NPPA application for details regarding the full NPPA application process.

To date, PHARMAC has received a total of 48 NPPA applications for ustekinumab for the use in treatment of various indications. Of these:

• 3 applications have been approved
• 1 application has been withdrawn by the applicant
• 44 applications have been declined due to the NPPA principles not being met.

We trust that this information answers your queries. We are making our information more freely available, so we will now publish selected OIA responses (excluding personal details) on our website.  Please get in touch with us if you have any questions about this.

Yours sincerely 

Rachel Read
Manager, Policy and Government Services