New funding applications
Making a funding application
Anyone – a patient, a health professional, or a pharmaceutical supplier – can make a funding application to PHARMAC.
Most applications are provided by pharmaceutical companies, who have access to the full range of information PHARMAC requires to assess applications.
We recognise that not all clinicians or consumers will have access to this detailed information, so we've created a form that can be filled out and provided to PHARMAC, which we can then use to collate the information required.
Clinicians and consumers can use the form below to begin a funding application for a Pharmaceutical Schedule listing. You may need to save the document to your computer before you are able to use it.
Pharmaceutical suppliers should continue to refer to the Guidelines for Funding Applications to PHARMAC for guidance on how to submit funding applications. These reflect the Factors for Consideration and indicate information we will require in a funding application to assess it against the Factors.
What happens next
New funding applications are referred to one of PHARMAC's Therapeutic Group Managers (TGMs), who'll seek more information and appropriate clinical advice, including from the Pharmacology and Therapeutics Advisory Committee (PTAC) or one of the specialist PTAC subcommittees.
Our clinical advisors may either refer the application back to the TGM for further information or additional clinical advice, or make a recommendation about whether to fund the medicine and what priority level it should be given by PHARMAC.
Should PHARMAC decide to proceed with the application, the TGM will negotiate with the supplier to reach a provisional agreement. PHARMAC then usually consults with the health sector on the proposal and takes this feedback into account before making a final decision. Decisions are usually made by the PHARMAC Board, or by the Chief Executive acting under authority of the Board.
Decisions are then notified to the health sector and the Pharmaceutical Schedule is updated.
Checking on the progress of an application
The application tracker details the progress of applications received since 2008, and of all but a small number of applications since 2002.
PHARMAC uses a range of purchasing strategies to enable the best value to be obtained from the pharmaceutical budget.
Reference pricing means that all pharmaceuticals in any given therapeutic sub-group, to which PHARMAC decides to apply reference pricing, are subsidised at the level of the lowest priced pharmaceutical in that sub-group. Reference pricing is based on the classification of pharmaceuticals into different therapeutic groups and further into sub-groups.
A therapeutic group is defined as a set of pharmaceuticals which are used to treat the same or similar condition(s). A therapeutic sub-group is defined as a set of pharmaceuticals which produce the same or similar therapeutic effect in treating the same or similar condition(s).
PHARMAC uses a Tender to negotiate sole-supply contracts for off-patent pharmaceuticals. This involves issuing tender documents to pharmaceutical suppliers inviting their bids for a set list of pharmaceuticals. Usually the Tender awards three-year sole supply contracts to successful bidders.
Nearly a third of the approximately 1700 formulations listed on the Pharmaceutical Schedule are sourced through the Tender.
Caps and rebates
Contracts with suppliers will sometimes include an agreement to cap expenditure at a certain level, with the supplier agreeing to reimburse the cost of the pharmaceutical in excess of the cap in the form of rebates to PHARMAC.
Product change notifications
Last updated: 22 January 2019