Decision to fund two treatment combinations and widen access to ibrutinib for chronic lymphocytic leukaemia (CLL)

9 April 2026

Medicines Decision

What we’re doing

We're pleased to announce a decision to fund two fixed duration combinations therapies and widen access to an existing treatment for people with chronic lymphocytic leukaemia (CLL).

From 1 May 2026, the following changes will be implemented:

Venetoclax (Venclexta) in combination with ibrutinib (Imbruvica) – Funded as a first line treatment option
Venetoclax (Venclexta) in combination with obinutuzumab (Gazyva) – Funded as a first line treatment option
Ibrutinib (Imbruvica) – Widened access as a second line treatment for people with CLL regardless of their specific cancer mutation

This decision was subject to a consultation letter dated 18 February 2026. We received feedback from a wide range of stakeholders including consumers, their whānau and families, clinicians, pharmacists and patient support groups. We’re grateful to everyone for their feedback and have made some changes to the original proposals as a result. A summary of the main feedback themes raised for each part of this proposal, and our responses to these, are detailed further in this document.

Who we think will be most interested

People with CLL, their whānau, and caregivers
Haematologists, oncologists, and health professionals involved in the care of people with CLL
Groups who support and advocate for people with CLL
Health New Zealand | Te Whatu Ora
Cancer Control Agency | Te Aho o Te Kahu
Pharmaceutical suppliers and wholesalers

What does this mean for people?

From 1 May 2026, venetoclax with ibrutinib and venetoclax with obinutuzumab will be funded as first line combination treatments. The funding for ibrutinib will also be widened so it can be used on its own as a second line treatment for people whose CLL has not responded to a previous treatment, has come back, or where earlier treatment caused intolerable side effects.

We anticipate that around 110 people each year will benefit from one of the combination treatments, and around 30 people each year will benefit from widened access to ibrutinib.

This decision will also help reduce the demand on health sector services as these are oral treatments reduce the need for hospital-based infusions. We anticipate that this decision will save approximately 3,700 infusion hours per year. We acknowledge that obinutuzumab is an infusion and appreciate the significant workload requirements for nursing and hospital staff, especially when people are starting on treatment.

Any changes to the original proposal?

Following consultation, changes have been made to the wording of the Special Authority criteria to improve clarity for clinicians. We have also removed the proposed renewal criteria and set the initial approval period to match the fixed-duration treatments.

We’ve changed the access criteria so that people who have been self‑funding venetoclax or ibrutinib can switch to the funded combination treatment, where it is clinically appropriate. This switch to combination treatment will need to be made within six months of the funding date (before 1 November 2026).

We are also widening access to ibrutinib to be used as a second line treatment for people with CLL who relapse or are intolerant to first line treatment. The funding criteria for rituximab has been amended to ensure people can still access rituximab in combination with venetoclax as a second line treatment option.

While we weren’t able to make every change that was suggested through this proposal, the feedback helped shape this decision and will continue to inform future work.

Detail about this decision

Venetoclax funding criteria

From 1 May 2026, venetoclax would be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria (new criteria and amended criteria shown only, additions in bold, deletions in strikethrough):

Special Authority for Subsidy

Initial application - (previously untreated chronic lymphocytic leukaemia in combination with obinutuzumab) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria:

Either:

Individual is currently on treatment with venetoclax and obinutuzumab and met all of the following criteria prior to commencing treatment; or
All of the following:
1. Individual has previously untreated chronic lymphocytic leukaemia; and
2. Venetoclax is to be administered with obinutuzumab; and
3. Venetoclax is to be used to a maximum dose of 400 mg and for a total of 12 (28 day) cycles*.

Note: *maximum number of cycles refers to 12 cycles of full dose venetoclax, in addition to the initial 5-week dose ramp-up period.

Initial application - (previously untreated chronic lymphocytic leukaemia in combination with ibrutinib) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria:

Either:

Individual is currently on treatment with venetoclax and/or ibrutinib and met all of the following criteria prior to commencing treatment; or
All of the following:
1. Individual has previously untreated chronic lymphocytic leukaemia; and
2. Venetoclax is to be administered in combination with ibrutinib; and
3. Venetoclax is to be used to a maximum dose of 400 mg and for a total of 12 (28 day) cycles*.

Note: *maximum number of cycles refers to 12 cycles of full dose venetoclax, in addition to the initial 5-week dose ramp-up period.

Initial application - (relapsed/refractory chronic lymphocytic leukaemia) from any relevant practitioner. Approvals valid for 8 months for applications meeting the following criteria:

All of the following:

Individual has chronic lymphocytic leukaemia requiring treatment; and
Individual has received at least one prior therapy for chronic lymphocytic leukaemia; and
3. Individual has not previously received funded venetoclax; and
The individual’s disease has relapsed; and
Venetoclax to be used in combination with six 28-day cycles of rituximab commencing after the 5-week dose titration schedule with venetoclax; and
Individual has an ECOG performance status of 0-2.

Renewal - (relapsed/refractory chronic lymphocytic leukaemia) from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria:

Both:

Treatment remains clinically appropriate and the individual is benefitting from and tolerating treatment; and
Venetoclax is to be discontinued after a maximum of 24 months of treatment following the titration schedule unless earlier discontinuation is required due to disease progression or unacceptable toxicity.

Note: ‘Chronic lymphocytic leukaemia (CLL)’ includes small lymphocytic lymphoma (SLL) and B-cell prolymphocytic leukaemia (B-PLL)*. Indications marked with * are unapproved indications.

From 1 November 2026, the eligibility criteria will change for the combination treatment. The criterion allowing access for people who are currently receiving treatment will be removed as this provision is time limited to six months to allow people to switch to the combination treatment if clinically appropriate.

Either:

Individual is currently on treatment with venetoclax and/or ibrutinib and met all of the following criteria prior to commencing treatment; or
All of the following:
1. Individual has previously untreated chronic lymphocytic leukaemia; and
2. Venetoclax is to be administered in combination with ibrutinib; and
3. Venetoclax is to be used to a maximum dose of 400 mg and for a total of 12 (28 day) cycles*.

Note: *maximum number of cycles refers to 12 cycles of full dose venetoclax, in addition to the initial 5-week dose ramp-up period.

Similar eligibility criteria would apply in Part II of Section H of the Pharmaceutical Schedule.

Ibrutinib funding criteria

From 1 May 2026 ibrutinib would be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria (new criteria and amended criteria shown only, additions in bold, deletions in strikethrough):

Special Authority for Subsidy

Initial application - (previously untreated chronic lymphocytic leukaemia in combination with venetoclax) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria:

Either:

Individual is currently on treatment with ibrutinib and/or venetoclax and met all of the following criteria prior to commencing treatment; or
Both:
1. Individual has previously untreated CLL; and
2. Ibrutinib is to be administered at a maximum dose of 420 mg daily for 3 (28 day) cycles as monotherapy, followed by a maximum of 12 (28 day) cycles in combination with venetoclax.

Initial application - (chronic lymphocytic leukaemia (CLL)) from any relevant practitioner.

Approvals valid for 6 months for applications meeting the following criteria:

All of the following:

Individual has chronic lymphocytic leukaemia (CLL) requiring therapy; and
Individual has not previously received funded ibrutinib; and
Ibrutinib is to be used as monotherapy; and
4 Any of the following Individual has experienced intolerable side effects, or their disease has relapsed or is refractory following at least one prior line of therapy; and
~~4.1 Both:~~
~~4.1.1 There is documentation confirming that the individual has 17p deletion or TP53 mutation; and~~
~~4.1.2 Individual has experienced intolerable side effects with venetoclax monotherapy; or~~
~~4.2 All of the following:~~
~~4.2.1 Individual has received at least one prior immunochemotherapy for CLL; and~~
~~4.2.2 Individual’s CLL has relapsed; and~~
~~4.2.3 Individual has experienced intolerable side effects with venetoclax in combination with rituximab regimen; or~~
~~4.3 Individual’s CLL is refractory to or has relapsed following a venetoclax regimen.~~
Individual has not received ibrutinib monotherapy previously.

Renewal - (chronic lymphocytic leukaemia (CLL)) from any relevant practitioner.

Approvals valid for 12 months where there is no evidence of disease progression.

Note: ‘Chronic lymphocytic leukaemia (CLL)’ includes small lymphocytic lymphoma (SLL) and B-cell prolymphocytic leukaemia (B-PLL)*. Indications marked with * are Unapproved indications.

From 1 November 2026, the eligibility criteria will change for the combination treatment. The criterion allowing people who are currently receiving treatment will be removed as this provision is time limited to six months to allow people to switch to the combination treatment if clinically appropriate.

Special Authority for Subsidy

Either:

1. Individual is currently on treatment with ibrutinib and/or venetoclax and met all of the following criteria prior to commencing treatment; or

Both:
1. Individual has previously untreated CLL; and
2. Ibrutinib is to be administered at a maximum dose of 420 mg daily for 3 (28 day) cycles as monotherapy, followed by a maximum of 12 (28 day) cycles in combination with venetoclax.

Similar eligibility criteria would apply in Part II of Section H of the Pharmaceutical Schedule.

Obinutuzumab funding criteria

From 1 May 2026 obinutuzumab would be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria (new criteria shown only):

Special Authority for Subsidy

Either:

Individual is currently on treatment with obinutuzumab and venetoclax and met all of the following criteria prior to commencing treatment; or
Both:
1. Individual has previously untreated chronic lymphocytic leukaemia; and
2. Obinutuzumab is to be administered at a maximum cumulative dose of 8,000 mg and in combination with venetoclax for a maximum of 6 (28-day) cycles of treatment.

Similar eligibility criteria would apply in Part II of Section H of the Pharmaceutical Schedule.

Rituximab funding criteria

From 1 May 2026 rituximab (Riximyo) would be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria (amended criteria shown only):

Special Authority for Subsidy

Initial application — (Chronic lymphocytic leukaemia) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria:

All of the following:

The patient has progressive Binet stage A, B or C chronic lymphocytic leukaemia (CLL) requiring treatment; and
Any of the following:
1. The patient is rituximab treatment naive; or
2. Either:
  1. The patient is chemotherapy treatment naive; or
  2. Both:
    1. The patient's disease has relapsed following no more than three prior lines of chemotherapy treatment; and
    2. The patient has had a treatment-free interval of 12 months or more if previously treated with fludarabine and cyclophosphamide chemotherapy; or
3. The patient’s disease has relapsed and rituximab treatment is to be used in combination with funded venetoclax; and
The patient has good performance status; and
4. Either:
4.1. The patient does not have chromosome 17p deletion CLL; or
4.2. Rituximab treatment is to be used in combination with funded venetoclax for relapsed/refractory chronic lymphocytic leukaemia; and
Rituximab to be administered in combination with fludarabine and cyclophosphamide, bendamustine or venetoclax for a maximum of 6 treatment cycles; and
It is planned that the patient receives full dose fludarabine and cyclophosphamide (orally or dose equivalent intravenous administration), bendamustine or venetoclax.

Note: 'Chronic lymphocytic leukaemia (CLL)' includes small lymphocytic lymphoma. A line of chemotherapy treatment is considered to comprise a known standard therapeutic chemotherapy regimen and supportive treatments. 'Good performance status' means ECOG score of 0-1, however, in patients temporarily debilitated by their CLL disease symptoms a higher ECOG (2 or 3) is acceptable where treatment with rituximab is expected to improve symptoms and improve ECOG score to < 2.

Renewal — (Chronic lymphocytic leukaemia) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria:

Both:

Either:
1. The patient’s disease has relapsed and rituximab treatment is to be used in combination with funded venetoclax; or
2. All of the following:
  1. The patient's disease has relapsed following no more than one prior line of treatment with rituximab for CLL; and
  2. The patient has had an interval of 36 months or more since commencement of initial rituximab treatment; and
    1.2.3. The patient does not have chromosome 17p deletion CLL; and
  3. It is planned that the patient receives full dose fludarabine and cyclophosphamide (orally or dose equivalent intravenous administration) or bendamustine; and
Rituximab to be administered in combination with fludarabine and cyclophosphamide, bendamustine or venetoclax for a maximum of 6 treatment cycles.

These changes to rituximab criteria are to ensure venetoclax and rituximab are able to be used in combination as a second line treatment regardless of TP53 mutational status. It also ensures venetoclax and rituximab is able to be used as a third line treatment following ibrutinib monotherapy if needed.

Similar eligibility criteria would apply in Part II of Section H of the Pharmaceutical Schedule.

Our response to what you told us

We’re grateful for the time people took to respond to this consultation. A summary of the main themes raised in feedback, our responses to the feedback received, and changes we have made after listening to you are in the table below.

Theme	Pharmac Comment
General support for the proposal
Patients, whānau, clinicians, and advocacy groups Respondents provided strong support for funding venetoclax‑based first‑line combinations; reduced toxicity, fewer hospital visits, alignment with guidelines, and relief from financial hardship; fixed‑duration therapy improves quality of life and access.	We are pleased to be progressing a proposal that would benefit New Zealanders.
Clinicians and advocacy groups Highlighted system benefits of oral treatments (reduced infusion and nursing time). In contrast one respondent noted that obinutuzumab administration requires significant nursing time and support in the first 5 weeks.	We note the health system benefits from an oral treatment option for individuals and are pleased to be progressing this proposal. We acknowledge and appreciate the significant workload requirements for nursing and hospital staff with obinutuzumab infusions, especially when individuals are starting on treatment. We have shared our estimates of these with HNZ to help with their planning.
Special Authority restrictions
Clinicians, consumer, and supplier Request to remove the renewals for all treatments because these are fixed‑duration and renewal adds admin with little clinical value.	We are grateful for the feedback and have sought advice on this change. Our clinical advisors are supportive and as such we are removing the renewal criteria and extending the initial approval period to cover the whole treatment course.
Clinicians Requested a note be added to the venetoclax criteria to clarify that the maximum duration of 12 cycles refers to the period of time on full dose venetoclax and that this is in addition to the 5 week ramp-up period.	We appreciate the feedback and have included a note in the venetoclax criteria to this effect.
Clinician Requested additional text be included in the ibrutinib criteria to clarify the usage with venetoclax.	We appreciate the feedback and have amended the criteria accordingly.
Clinicians Requested a change to the criteria to remove the requirement for prior immunochemotherapy in the initial application for ibrutinib for relapsed or refractory CLL.	We appreciate the feedback and have amended the criteria accordingly.
Supplier Request to remove the maximum dose of venetoclax from the special authority to align with current criteria.	We sought advice from CTAC on the requested changes to the funding criteria and CTAC considered it was reasonable to retain the maximum dosing. We note that maximum dosing is included for all treatments in this proposal as they are fixed duration.
Clinicians and advocacy group Request to amend the criteria for venetoclax and ibrutinib to allow patients who are self-funding one treatment to move to the fixed duration combination treatment.	We have amended the criteria to allow people who have self-funded one treatment, a time-limited period, to switch to the funded combination treatment. This ensures that these people can access first line treatment with combination therapy along with others who have CLL. We note that switching from single treatment to the combination would need to be a decision made based on clinician judgement between a person and their clinician.
Clinicians and advocacy group Request to allow venetoclax to be funded in combination with any BTK inhibitor. This would allow patients the choice to self-fund an alternative to ibrutinib.	We acknowledge the desire to have options for alternative BTK inhibitors. When CTAC reviewed the combination treatment they acknowledged that there may be benefit for other BTK inhibitors to be used with venetoclax, but there is not currently evidence to support this. Until evidence of efficacy of other BTK inhibitors is available in this context, their recommendation for funding is only for ibrutinib. As such, we are not proposing to change the criteria to allow any BTK inhibitor to be used.
Clinicians and advocacy group Highlighted that there may be some patients who get side effects from either of these combination treatments. It would be essential to understand if a Named Patient Pharmaceutical Assessment (NPPA) would be option for these people to access a second generation BTK inhibitor.	We recognise that not all people will tolerate these treatment combinations. Where an individual experiences clinically significant adverse side effects, clinicians may consider submitting a NPPA application to Pharmac for an alternative treatment. Any successful application would need to demonstrate that the principles of the NPPA policy are met, including consideration of why ibrutinib would not be appropriate, noting the proposal now includes funding ibrutinib monotherapy second line. Making a NPPA application
Clinicians and advocacy group Requested that Pharmac fund both combination treatments as second-line options for people who have relapsed on chemotherapy under the current treatment paradigm.	We recognise there is an unmet health need for people who have relapsed on first line treatment options. We have not received a funding application for these combinations in a second line setting. Funding these treatments in the relapsed/refractory setting would require further assessment on the evidence and cost effectiveness and we have therefore not actioned this request. We would welcome a funding application for these treatments in second line. More information about how to submit a funding application is available on our website. Make a medicine funding application
Other funding requests
Patients, whānau, and clinicians Highlighted the unmet need for second generation BTK inhibitors (zanubrutinib, acalabrutinib).	We acknowledge the unmet need for these treatments and funding applications for these have been assessed and are ranked on our Options for Investment list. This means they are treatments we would like to fund if we have available budget.
Scientist Request for a nationwide monitoring protocol to ensure the effectiveness of these treatments.	We recognise the importance of monitoring. While ongoing clinical monitoring is outside Pharmac’s scope, we work with Health New Zealand to understand wider system impacts of funding decisions, including laboratory testing.
Patients, clinicians Requested first‑line funded ibrutinib monotherapy, irrespective of mutational status, for people currently self‑funding to avoid switching to combination therapy.	The proposal was to fund combination treatment in the first line setting. We acknowledge some people may be self-funding ibrutinib as monotherapy currently and there would be 6 months for those people to change to funded combination treatment if clinically appropriate. Pharmac has applications for two first‑line monotherapy BTK inhibitors ranked on the Options for Investment list and these are medicines we would like to fund when we have budget to do so.
Patients, clinicians Requested second line funded ibrutinib monotherapy for people who relapse or are intolerant to a first line treatment.	We appreciate the feedback and understand that there is a health need for funded second‑line ibrutinib monotherapy. As a result of the feedback, and additional clinical advice, we are widening access to ibrutinib to allow this to be used in second line. This also ensures that people who received chemotherapy as first line treatment can access ibrutinib as their next treatment.
Clarity on proposal
Individual Requested clarification on what “fixed duration" will mean.	For these treatments, the ‘fixed duration’ refers to the length of time treatment was used in the clinical trials. This is based on the clinical advice we received from our expert clinical advisors CTAC, the maximum doses and durations for each treatment align with the clinical trial evidence and international guidelines. More details about the clinical advice we received on treatment duration are available in the record of the Oct 2023 meeting. Record of October 2023 meeting of the Cancer Treatment Advisory Committee [PDF, 991 KB]
Pharmacist Requested clarity on the application of the transitional access policy. If an individual received the first doses of obinutuzumab as an inpatient in a public hospital, would they be able to receive the rest of the treatment funded in a private clinic. If cycle 1, day 1 is the accepted date for transitional access eligibility, regardless of public administration.	The transitional access policy was implemented by the government. If a person is receiving treatment in a private setting at the time of funding (regardless of where the first dose was given), they would be eligible for funded treatment. All other situations are outside of the policy. If a person starts treatment after the transition period and receives the first dose in public, the remaining treatment cycles would not be funded for administration in a private facility.

Theme

Pharmac Comment

General support for the proposal

Patients, whānau, clinicians, and advocacy groups

Respondents provided strong support for funding venetoclax‑based first‑line combinations; reduced toxicity, fewer hospital visits, alignment with guidelines, and relief from financial hardship; fixed‑duration therapy improves quality of life and access.

We are pleased to be progressing a proposal that would benefit New Zealanders.

Clinicians and advocacy groups

Highlighted system benefits of oral treatments (reduced infusion and nursing time). In contrast one respondent noted that obinutuzumab administration requires significant nursing time and support in the first 5 weeks.

We note the health system benefits from an oral treatment option for individuals and are pleased to be progressing this proposal.

We acknowledge and appreciate the significant workload requirements for nursing and hospital staff with obinutuzumab infusions, especially when individuals are starting on treatment. We have shared our estimates of these with HNZ to help with their planning.

Special Authority restrictions

Clinicians, consumer, and supplier

Request to remove the renewals for all treatments because these are fixed‑duration and renewal adds admin with little clinical value.

We are grateful for the feedback and have sought advice on this change. Our clinical advisors are supportive and as such we are removing the renewal criteria and extending the initial approval period to cover the whole treatment course.

Clinicians

Requested a note be added to the venetoclax criteria to clarify that the maximum duration of 12 cycles refers to the period of time on full dose venetoclax and that this is in addition to the 5 week ramp-up period.

We appreciate the feedback and have included a note in the venetoclax criteria to this effect.

Clinician

Requested additional text be included in the ibrutinib criteria to clarify the usage with venetoclax.

We appreciate the feedback and have amended the criteria accordingly.

Clinicians

Requested a change to the criteria to remove the requirement for prior immunochemotherapy in the initial application for ibrutinib for relapsed or refractory CLL.

We appreciate the feedback and have amended the criteria accordingly.

Supplier

Request to remove the maximum dose of venetoclax from the special authority to align with current criteria.

We sought advice from CTAC on the requested changes to the funding criteria and CTAC considered it was reasonable to retain the maximum dosing.

We note that maximum dosing is included for all treatments in this proposal as they are fixed duration.

Clinicians and advocacy group

Request to amend the criteria for venetoclax and ibrutinib to allow patients who are self-funding one treatment to move to the fixed duration combination treatment.

We have amended the criteria to allow people who have self-funded one treatment, a time-limited period, to switch to the funded combination treatment. This ensures that these people can access first line treatment with combination therapy along with others who have CLL.

We note that switching from single treatment to the combination would need to be a decision made based on clinician judgement between a person and their clinician.

Clinicians and advocacy group

Request to allow venetoclax to be funded in combination with any BTK inhibitor. This would allow patients the choice to self-fund an alternative to ibrutinib.

We acknowledge the desire to have options for alternative BTK inhibitors. When CTAC reviewed the combination treatment they acknowledged that there may be benefit for other BTK inhibitors to be used with venetoclax, but there is not currently evidence to support this. Until evidence of efficacy of other BTK inhibitors is available in this context, their recommendation for funding is only for ibrutinib.

As such, we are not proposing to change the criteria to allow any BTK inhibitor to be used.

Clinicians and advocacy group

Highlighted that there may be some patients who get side effects from either of these combination treatments. It would be essential to understand if a Named Patient Pharmaceutical Assessment (NPPA) would be option for these people to access a second generation BTK inhibitor.

We recognise that not all people will tolerate these treatment combinations. Where an individual experiences clinically significant adverse side effects, clinicians may consider submitting a NPPA application to Pharmac for an alternative treatment. Any successful application would need to demonstrate that the principles of the NPPA policy are met, including consideration of why ibrutinib would not be appropriate, noting the proposal now includes funding ibrutinib monotherapy second line.

Making a NPPA application

Clinicians and advocacy group

Requested that Pharmac fund both combination treatments as second-line options for people who have relapsed on chemotherapy under the current treatment paradigm.

We recognise there is an unmet health need for people who have relapsed on first line treatment options. We have not received a funding application for these combinations in a second line setting.

Funding these treatments in the relapsed/refractory setting would require further assessment on the evidence and cost effectiveness and we have therefore not actioned this request. We would welcome a funding application for these treatments in second line. More information about how to submit a funding application is available on our website.

Make a medicine funding application

Other funding requests

Patients, whānau, and clinicians

Highlighted the unmet need for second generation BTK inhibitors (zanubrutinib, acalabrutinib).

We acknowledge the unmet need for these treatments and funding applications for these have been assessed and are ranked on our Options for Investment list. This means they are treatments we would like to fund if we have available budget.

Scientist

Request for a nationwide monitoring protocol to ensure the effectiveness of these treatments.

We recognise the importance of monitoring. While ongoing clinical monitoring is outside Pharmac’s scope, we work with Health New Zealand to understand wider system impacts of funding decisions, including laboratory testing.

Patients, clinicians

Requested first‑line funded ibrutinib monotherapy, irrespective of mutational status, for people currently self‑funding to avoid switching to combination therapy.

The proposal was to fund combination treatment in the first line setting. We acknowledge some people may be self-funding ibrutinib as monotherapy currently and there would be 6 months for those people to change to funded combination treatment if clinically appropriate.

Pharmac has applications for two first‑line monotherapy BTK inhibitors ranked on the Options for Investment list and these are medicines we would like to fund when we have budget to do so.

Patients, clinicians

Requested second line funded ibrutinib monotherapy for people who relapse or are intolerant to a first line treatment.

We appreciate the feedback and understand that there is a health need for funded second‑line ibrutinib monotherapy.

As a result of the feedback, and additional clinical advice, we are widening access to ibrutinib to allow this to be used in second line.

This also ensures that people who received chemotherapy as first line treatment can access ibrutinib as their next treatment.

Clarity on proposal

Individual

Requested clarification on what “fixed duration" will mean.

For these treatments, the ‘fixed duration’ refers to the length of time treatment was used in the clinical trials. This is based on the clinical advice we received from our expert clinical advisors CTAC, the maximum doses and durations for each treatment align with the clinical trial evidence and international guidelines. More details about the clinical advice we received on treatment duration are available in the record of the Oct 2023 meeting.

Record of October 2023 meeting of the Cancer Treatment Advisory Committee [PDF, 991 KB]

Pharmacist

Requested clarity on the application of the transitional access policy.

If an individual received the first doses of obinutuzumab as an inpatient in a public hospital, would they be able to receive the rest of the treatment funded in a private clinic.

If cycle 1, day 1 is the accepted date for transitional access eligibility, regardless of public administration.

The transitional access policy was implemented by the government.

If a person is receiving treatment in a private setting at the time of funding (regardless of where the first dose was given), they would be eligible for funded treatment. All other situations are outside of the policy.

If a person starts treatment after the transition period and receives the first dose in public, the remaining treatment cycles would not be funded for administration in a private facility.

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.