Decision on changes to support increased prescription lengths

7 October 2025

What’s changing

From early 2026 medicines and other products will be funded for up to 12 months on a single prescription. This means some people will need prescriptions less often than they do now.

Prescribers will decide what prescription length is best for each person’s health needs. They may issue a prescription for up to 12 months, or for a shorter time if that’s more suitable.

People will still collect up to three months’ worth of medicine at a time from the pharmacy or up to six months of an oral contraceptive.

More about the changes to prescription lengths | Ministry of Health website(external link)

Any changes to the original proposal?

We made this decision after asking for feedback in a consultation released on 26 June 2025.

We appreciated the thoughtful feedback we received on the shift to longer prescriptions and we’re grateful for the insights that were shared. We've passed on relevant feedback and implementation recommendations to Health New Zealand, who are leading this transition.

We also carefully considered feedback about the potential impact of a fixed Special Authority expiry, which led us to update our approach.

The following changes to the proposal have been made since consultation:

Special Authority expiry

Currently, there’s some flexibility about when the Special Authority funding ends. If a product with a Special Authority is first dispensed before the expiry date, any remaining repeats up to the three-month prescription limit are funded, even if they are dispensed after the expiry date.

We consulted on a proposal to limit funding to dispensings made before the Special Authority expiry, regardless of prescription length.

Following strong consultation feedback, we’ve revised our approach. From early 2026, up to three months of dispensings will be funded, provided the prescription is first dispensed before the Special Authority approval expires.

Repeat dispensings

Consultation feedback highlighted concerns that people might expect to collect a full 12-month supply of medicine at once. We have decided to update the Schedule Rules to clarify the repeat dispensing arrangements for funded medicines.

Who may be most interested

People who are prescribed medicines
Prescribers
Pharmacists
Health care professional representative groups
Health New Zealand, including Sector Operations
Health system prescribing and dispensing software providers
Suppliers and wholesalers

Detail about this decision

The Government has decided to increase the length of prescriptions, through proposed changes to the Medicines Regulations 1984.

Currently, the regulations allow prescriptions for most medicines to be written for up to three months, except for oral contraceptives, which can be prescribed for up to six months.

Under the amended regulations, prescribers will be able to write prescriptions for any period up to 12 months.

The maximum amount of a medicine that can be dispensed at a time from a pharmacy will still be three months, or six months for an oral contraceptive.

Controlled drugs remain unchanged

There are no changes to how long controlled drugs, including Class B opioids, can be prescribed for. These medicines have strict limits under the Misuse of Drugs Act 1975. This means that controlled drugs will not be prescribed for longer periods than they are now.

Schedule changes

This decision means that funding of medicines and other products will be aligned with the amended regulations. This will be enabled through the following changes to the Pharmaceutical Schedule.

Schedule Rules

1.2 Community Pharmaceuticals periods of supply for Subsidy: Community Pharmaceuticals will be Subsidised only if the prescription under which the Community Pharmaceutical has been first been dispensed was presented to by the Contractor within 3 Months of the date on which the Prescription was written; and

1.2.1 Only a quantity sufficient to provide treatment up to the legal period of supply limit will be Subsidised as specified in the Medicines Act 1981 and Medicines Regulations 1984 and the Misuse of Drugs Act 1975 and Misuse of Drugs Regulations 1977.

1.2.2 Where there is no legal period of supply limit, only a quantity sufficient to provide treatment for a period up to 3 Months 12 Months will be Subsidised, subject to the dispensing requirements in 3.2 below.

2.4 Special Authority: Special Authority applications are approved or declined via an application process in which a Prescriber requests a Subsidy on a Community Pharmaceutical for a named person.

2.4.1 Special Authority approvals may be valid for a defined period, or without further renewal unless notified of a change.

2.4.2 The valid Special Authority number must be present on the Prescription

2.4.3 Repeat dispensings to complete the balance of up to 3 Months’ supply of the Community Pharmaceutical will be eligible for Subsidy if a Prescription is first dispensed before the Special Authority expiry date. This applies even if the repeats are collected after the Special Authority expiry date, unless the Pharmaceutical has been delisted from the Schedule.

3.2 Dispensing:

3.2.1 A Prescription, or part thereof, will be eligible for Subsidy if it is fulfilled within:

a in the case of a Prescription for the total supply of between 1 and 3 Months, 3 Months from the date the Community Pharmaceutical was first dispensed, or

b in any other case, 1 Month from the date the Community Pharmaceutical was first dispensed.

3.2.2 Only that part of any Prescription that is dispensed within the time frames specified above in rule 3.2.1 is eligible for Subsidy.

3.2.2 Only a quantity sufficient to provide treatment up to the legal maximum dispensing period as specified in the Medicines Act 1981 and Medicines Regulations 1984 and the Misuse of Drugs Act 1975 and Misuse of Drugs Regulations 1977 will be subsidised.

3.2.3 Where there is no legal maximum dispensing period, only a quantity sufficient to provide treatment for a period up to 3 Months in any single dispensing will be Subsidised, unless otherwise specified.

3.3 Repeat dispensings:

3.3 Oral contraceptives: A Prescription for an oral contraceptive, or part thereof, will only be eligible for Subsidy if it is fulfilled within:

3.3.1 3 Months from the date the Prescription was written, or

3.3.2 6 Months from the date the oral contraceptive was first dispensed if the quantity was dispensed in repeat dispensing.

3.3.1 Repeat dispensings will be eligible for Subsidy when the Contractor can reasonably determine that supply of the Community Pharmaceutical has been exhausted or at least 2 thirds of the dispensing period has elapsed since the previous dispensing of the Community Pharmaceutical or at least 2 thirds of supply of the Community Pharmaceutical has been used since the previous dispensing, or for a reason otherwise known to the Contractor such as the circumstances in 4.4.2.

3.3.2 In circumstances where the patient has lost or damaged the dispensed supply of the Community Pharmaceutical or has an increased need for the Community Pharmaceutical due to a change in dose or frequency, the Contractor may supply the Community Pharmaceutical at an earlier date to the periods specified in 3.3.1.

4.4 Community Pharmaceuticals identified in the Schedule without the ❋ or ▲ symbols

4.4.1 Default dispensing is Monthly Lots, or 10 day Lots for Class B opioid Controlled Drugs.

4.4.2 A Community Pharmaceutical, may be dispensed in a one 90 day Lots on a prescription, where legally permitted, in the following circumstances:

a. a patient or their representative signs the Prescription to qualify for single Lot dispensing. In signing the Prescription, the patient or their nominated representative must certify which of the following criteria the patient meets:

i they have limited physical mobility

ii they live and work more than 30 minutes from the nearest pharmacy by their normal form of transport

iii they are relocating to another area, or

iv they are travelling and will be away when the repeat dispensings are due.

Part 5 – Community Pharmaceutical Modified Dispensing Quantities

For the purposes of Part 5, modified dispensing means: less than a single three month or six month (90 or 180 day) Lot for Pharmaceuticals identified with ❋, and less than Monthly Lots for any other Pharmaceuticals.

Part 10 – Definitions

❋ 3 Months’ supply dispensed all at once at one time or, in the case of oral contraceptives, 6 months’ supply dispensed at one time all at once, unless modified dispensing quantities apply.

Maximum amounts funded on a prescription

We have modified some funding limits from an amount per prescription to an amount per period (or similar) on some products to accommodate longer prescriptions. People will continue to receive the same amount of funded medicine at each dispensing.

The Pharmaceutical Schedule will be updated with changes from the current limit descriptions on the amount prescribed from early 2026 as follows:

Product	Current limit	Updated limit
Diabetes
Liraglutide inj 6 mg per ml, 3 ml prefilled pen	3 pen cartridges per month, 9 per prescription	1.8 mg (0.1 prefilled pen injection) per day
Insulin Pen Needles	200 devices per prescription	200 devices per three months
Insulin Syringes, Disposable With Attached Needle	200 devices per prescription	200 devices per three months
Continuous Glucose Monitor Interoperable Sensor (9) And Transmitter (Dexcom G6)	1 device per prescription, 5 per year	1 device per three months 5 per year
Continuous Glucose Monitor Interoperable Sensor (9) And Transmitter (Dexcom G7)	9 devices per prescription, 40 per year	9 devices per three months, 40 per year
Continuous Glucose Monitor Interoperable Sensor (Freestyle Libre 3 Plus)	6 devices per prescription, 28 per year	6 devices per three months, 28 per year
Continuous Glucose Monitor Standalone Sensor (Dexcom One+)	9 devices per prescription, 40 per year	9 devices per three months, 40 per year
Continuous Glucose Monitor Standalone Sensor (Freestyle Libre 2 Plus)	6 devices per prescription, 28 per year	6 devices per three months, 28 per year
Continuous Glucose Monitor Standalone Sensor (Freestyle Libre 2)	7 devices per prescription, 29 per year	7 devices per three months, 29 per year
Insulin Pump Cartridge	50 devices per prescription, 190 per year	50 devices per three months, 190 per year
Insulin Pump Infusion Set (Steel Cannula)	5 sets per prescription, 19 sets per year	5 sets per three months, 19 sets per year
Insulin Pump Infusion Set (Steel Cannula, Straight Insertion)	5 sets per prescription, 19 sets per year	5 sets per three months,19 sets per year
Insulin Pump Infusion Set (Teflon Cannula)	5 sets per prescription, 19 sets per year	5 sets per three months, 19 sets per year
Insulin Pump Infusion Set (Teflon Cannula, Angle Insertion With Insertion Device)	5 sets per prescription, 19 sets per year	5 sets per three months, 19 sets per year
Insulin Pump Infusion Set (Teflon Cannula, Flexible Insertion With Insertion Device)	5 sets per prescription, 19 sets per year	5 sets per three months,19 sets per year
Insulin Pump Infusion Set (Teflon Cannula, Straight Insertion With Insertion Device)	5 sets per prescription, 19 sets per year	5 sets per three months, 19 sets per year
Insulin Pump Infusion Set (Teflon Cannula, Variable Insertion)	5 sets per prescription, 19 sets per year	5 sets per three months,19 sets per year
Insulin Pump Reservoir	90 cartridges per prescription, 360 reservoirs per year	90 cartridges per three months, 360 reservoirs per year
Vitamins
Colecalciferol Cap 1.25 Mg (50,000 Iu)	12 caps per prescription	12 caps per three months
Antiacne preparations
Adapalene Gel 1%	30 g per prescription	30 g per three months
Tretinoin Cream 0.5 mg per g	50 g per prescription	50 g per three months

Approval length of products funded under Special Authority

From early 2026 the approval periods for the following Special Authority products will be increased to give enough time for the intended course of treatment to be dispensed before the approval expires.

Venetoclax

Initial application — relapsed/refractory chronic lymphocytic leukaemia

Applications from any relevant practitioner. Approvals valid for 7 8 months

Buprenorphine with naloxone

Initial application — Detoxification

Applications from any medical practitioner. Approvals valid for 1 month 6 weeks.

Renewal — Detoxification

Applications from any medical practitioner. Approvals valid for 1 month 6 weeks.

Upadacitinib

Initial application — Rheumatoid Arthritis (previously treated with adalimumab or etanercept) Applications from any relevant practitioner. Approvals valid for 6 7 months

Pazopanib (metastatic renal cell carcinoma)

Initial application

Applications only from a relevant specialist or any relevant practitioner on the recommendation of a relevant specialist. Approvals valid for 3 4 months

Omalizumab

Initial application — severe chronic spontaneous urticaria

Applications only from a clinical immunologist or dermatologist. Approvals valid for 6 7 months

Everolimus (tuberous sclerosis)

Initial application

Applications only from a neurologist or oncologist. Approvals valid for 3 4 months

What you told us

Thank you to the people who took time to respond to this consultation. A summary of the main themes raised in feedback and our responses to the feedback can be seen in the table below.

Theme	Pharmac comment
Access & Convenience
Generally supportive of longer prescriptions. Reduced frequency of GP visits makes it easier for those with limited access.	We are pleased that some people anticipate there will benefits to patients. We’ve shared the feedback about vulnerable and high-needs populations with our sector partners (Health New Zealand and the Ministry of Health) to support their planning and ensure people’s needs are considered.
Vulnerable populations (rural, Māori, Pacific, low-income) may face greater barriers and reduced engagement.
Reduced pharmacist contact undermines support for high-needs patients.
Clinical safety and monitoring
Support with 3-month dispensing and safeguards, such as prescribing guidance.	We agree that prescribers should continue to determine the clinically appropriate prescription length within the new arrangements. Pharmac is responsible for implementing the funding arrangements to support the Government’s decision. We’ve shared these clinical concerns and recommendations with our sector partners to help them support clinicians and people affected by the change.
12-month prescriptions should be limited to eligible patients with stable conditions.
Unsupportive of longer prescriptions. Unsafe for high-risk or unstable conditions and for some patient groups and products.
Concern that reduced patient monitoring may lead to missed diagnoses, delayed care, and increased morbidity/mortality.
Risk of medication wastage due to therapy changes or non-adherence
Special Authority (SA) Alignment
Support fixed SA expiry tied to dispensings in principle, with recommendations for system improvements.	We sincerely appreciate the feedback we received about the potential impact of a fixed Special Authority expiry. It has led us to update our approach. We’ve heard the strong call to reduce any unnecessary administrative burden associated with Special Authority renewals. We’ve been actively considering these concerns as we fund new treatments and listing Special Authority medicines without a renewal requirement where appropriate. We are removing Special Authority Renewal requirements on selected products(external link) by 1 February 2026. Special Authority renewals can be applied for up to six months before the current approval expires, regardless of the total approval period. This would remain, helping ensure people continue to receive funded medicines without interruption.
There are unlikely to be a significant number of SA medications that clinicians would consider appropriate to issue a 12-month prescription for.
Timeframes for SA renewal must remain distinct from prescription length to ensure patient safety is not compromised.
Call for review of SAs with renewals.
Limit prescription lengths for SA products.
SA expiry mid-prescription causes unfunded dispensing, delays, and administrative burden. GPs may charge patients for SA-related administration. Calls to keep existing SA expiry rules or defer until post-implementation review.
Prescribers should be able to renew SA before expiry.
Special Authority (SA) approval length changes
Support for the proposal to increase the approval periods for the listed Special Authority products.	We are pleased to be progressing this part of the proposal.
Software and system integration
Support for the changes if systems can be improved. Multiple suggestions on specific technical improvements to software and systems that could support the proposed changes.	We have shared feedback and suggestions on system improvements and non-transferable repeats with Health New Zealand, who are leading the system changes required for implementation of 12-month prescriptions.
Current systems are outdated. They have inadequate clinical decision support and lack SA expiry alerts.
Repeats not being transferable between pharmacies are problematic for people relocating or travelling.
Workload and remuneration
Support the proposal if funding is adjusted.	We acknowledge that some stakeholders have expressed concerns about increased administrative burden. We have shared these perspectives with our sector partners. Health NZ manages contracts with community pharmacies for dispensing funded medicines. We have shared this feedback with Health New Zealand.
Increased workload and administrative burden for prescribers and pharmacists Pharmacies face revenue loss per patient under current ICPSA fee structure, with financial and operational unsustainability for pharmacies.
Public education and expectations
Ensure Māori and Pacific communities are consulted and supported. Provide multilingual and culturally appropriate resources.	We understand the importance of accessible and culturally appropriate messaging to ensure people feel informed and empowered about proposed changes to funded medicines. We've shared this feedback with Health New Zealand, to support the development of resources
Concern about public expectations and potential for prescriber coercion. Patients may misunderstand the policy and expect to collect the full 12-month supply at once.
Implementation and communication recommendations
Launch public education campaigns via TV, radio, social media. Manage public expectations and ensure clarity on co-payment structures and collection intervals. Train prescribers and pharmacists on new rules and risks.	We appreciate the strong sector engagement, and the thoughtful suggestions provided to support the implementation of longer prescriptions. We are working closely with our sector partners who are coordinating delivery on these shared goals.
Controlled drugs (CDs)
Some respondents had questions and comments about controlled drugs in relation to longer prescriptions.	Controlled drugs are excluded from the 12-month prescription changes. This means that all classes of controlled drugs will not be prescribed for longer periods than they are now.
Product-specific feedback
Limits are too low for insulin pen needles and CGM sensors.	This decision updates these limit descriptions for 12-month prescriptions. These limits are designed to support fair and consistent access to funded medicines, but they are not intended to guide clinical practice. We are not reviewing the appropriateness of the limit for each product at this time but are open to doing so in future.
Limits on adapalene and isotretinoin cream may not meet clinical needs of all patients.
Concern that colecalciferol limit may be too high for standard prescribing.
Other
One respondent had questions about the enforcement and monitoring of maximum funded quantities across multiple pharmacies and sharing of responsibility between prescribers and pharmacists for SA renewals and dispensing compliance.	The current arrangements for the matters raised in these questions will continue.
Feedback on current regulatory conflicts between definitions of dispensing periods and suggestions for change.	We appreciate the time and effort taken to consider and articulate these concerns. However, they fall outside the scope of this proposal.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll-free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.