Proposal to fund medicines for multiple sclerosis, eye conditions, breast cancer and lung cancer

Medicines Consultation Closes 08 Oct

What we’re proposing

Tell us what you think about this proposal to fund treatments for multiple sclerosis, eye conditions, breast cancer and lung cancer through a provisional agreement with Roche Products (NZ) Limited (Roche). The proposal includes:

  • Ocrelizumab (Ocrevus SC) - a new injection (subcutaneous, SC) version of an already funded intravenous (IV) infusion medicine for multiple sclerosis.
  • Pertuzumab with trastuzumab (Phesgo) - a new combined injection (subcutaneous) version of two already funded intravenous (IV) infusion medicines for HER2-positive metastatic breast cancer.
  • Faricimab (Vabysmo) - a new injection treatment for people with diabetic macular oedema and wet age-related macular degeneration (eye conditions).
  • Entrectinib (Rozlytrek) - a new oral treatment for people with ROS1-positive non-small cell lung cancer.
  • Bevacizumab (Avastin) - secured ongoing access to this already funded injection treatment for people with certain eye conditions.

If approved, these medicines would be funded from 1 December 2025.

There are also proposed changes to the contract arrangements for some other medicines supplied by Roche, as well as widening the types of applicants who can apply for funded rituximab (Mabthera) for rheumatoid arthritis and obinutuzumab (Gazyva) for chronic lymphocytic leukaemia and follicular / marginal zone lymphoma. 

This multiproduct agreement we have negotiated with Roche provides savings on currently funded medicines which helps us to make new medicines available for New Zealanders. 

Impact of the proposal

We estimate that around 1,700 people would benefit from these treatments in the first year of funding, increasing to 4,000 people after five years. 

We also expect that this proposal could help reduce some demand on hospital infusion services. The availability of SC ocrelizumab, and SC pertuzumab with trastuzumab is anticipated to save around 7,500 infusion hours in the first year, increasing to a saving of 12,800 hours in the fifth year. Further efficiencies are also expected for the health sector as faricimab may be given less often than current treatment for some people. 

We have also heard from New Zealand ophthalmologists that it is important for the Avastin brand of bevacizumab to remain available for people with ocular conditions. 

We are pleased that this proposal is enabling the supply of new medicines for New Zealanders, as well as ensuring Avastin remains available for people who need it.

Consultation closes at 5pm, Wednesday 8 October, 2025 and feedback can be submitted via our online form.

Feedback on proposal to fund medicines for multiple sclerosis, eye conditions, breast cancer and lung cancer

Subcutaneous ocrelizumab for multiple sclerosis

What would the effect be?

A new formulation of ocrelizumab would be funded for everyone currently eligible for funded ocrelizumab from 1 December 2025. Subcutaneous (SC) ocrelizumab can be given faster than the currently funded intravenous (IV) infusion. This would mean that people could get the same treatment benefit but spend less time receiving treatment.

It’s estimated that most people receiving ocrelizumab would change to the SC formulation. People currently receiving ocrelizumab would be able receive the SC formulation, as well as people new to ocrelizumab treatment.

Who may be interested

  • People with multiple sclerosis, their family, whānau, friends and caregivers
  • Healthcare professionals involved in the care of people with multiple sclerosis
  • Te Whatu Ora – Health New Zealand hospitals and other organisations who deliver services and support for people, and their whānau who are affected by multiple sclerosis
  • People or groups with an interest in treatments for multiple sclerosis
  • Pharmacies and wholesalers
  • Pharmaceutical suppliers

About multiple sclerosis and subcutaneous ocrelizumab (Ocrevus SC)

Multiple sclerosis (MS) is an autoimmune condition where the immune system attacks the central nervous system. It may cause numerous sensory and physical symptoms, and often progresses to physical and cognitive disability. Relapsing remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS) are both types of MS.

Ocrelizumab is already funded as an IV infusion for people with RRMS and PPMS, subject to eligibility criteria. Currently, around 1,000 people are receiving ocrelizumab. Ocrelizumab helps to improve people’s quality of life as it slows the progression to more severe illness and helps to enable people to live more independently.

The proposal is to fund a new injection (SC) version, which can be given much faster than the current IV treatment. This means people could spend less time receiving treatment, and in future, may be able to have their treatment closer to home.

SC ocrelizumab is given under the supervision of a healthcare professional; people wouldn’t inject themselves. It's expected that when first funded, SC ocrelizumab would be given in hospital outpatient services (where IV treatment currently is given). Over time treatment may be rolled out to centres close to home for people, like community-based infusion centres.

Pharmac’s funding of the medicine would be in place for both community and hospital settings from its listing on 1 December 2025. We would like to hear from people in the health sector what Pharmac could do to support the accessibility of the SC formulation.

Why we’re proposing this

Roche submitted a funding application for SC ocrelizumab in August 2024. In April 2025 our clinical advisors on the Pharmacology and Therapeutics Advisory Committee (PTAC) recommended that SC ocrelizumab should be funded with a high priority. You can read more about the advice here:

Application Tracker | ocrelizumab subcutaneous formulation(external link)

Details about our proposal

From 1 December 2025, SC ocrelizumab would be listed on Section B and Part II of Section H of the Pharmaceutical Schedule, as follows:

Chemical Formulation Brand Pack size Price and subsidy
Ocrelizumab Inj 40 mg per ml, 23 ml vial Ocrevus SC 1 $16,900.00

A confidential rebate would apply to Ocrevus SC that would reduce its net price.

SC ocrelizumab would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule under the same eligibility criteria as IV ocrelizumab available on the Pharmaceutical Schedule(external link).

Subcutaneous pertuzumab with trastuzumab for HER2-positive metastatic breast cancer

What would the effect be?

A new combined formulation of pertuzumab with trastuzumab (Phesgo) would be funded for people with HER2-positive metastatic breast cancer from 1 December 2025. Subcutaneous (SC) pertuzumab with trastuzumab can be given faster than the IV infusions that people currently receive. This would mean that people would get the same treatment benefit that they currently do but could spend less time receiving treatment.

It’s estimated that from 1 December 2025, most people starting treatment with pertuzumab with trastuzumab would use the SC formulation; some people currently receiving IV treatment may also change to the new formulation. We anticipate around 100 people would benefit in the first year of funding.

Who may be interested

  • People with breast cancer, their family, whānau, friends and caregivers
  • Healthcare professionals involved in the care of people with breast cancer
  • Groups who support and advocate for people with cancer
  • Health NZ | Te Whatu Ora and Te Aho o Te Kahu | The Cancer Control Agency
  • Hei Āhuru Mōwai
  • Pharmacies and wholesalers
  • Pharmaceutical suppliers

About metastatic breast cancer and subcutaneous pertuzumab with trastuzumab

Breast cancer is one of the most common cancers in New Zealand. Some breast cancers are HER2-positive, which means they have higher levels of a protein that makes the cancer grow faster.

Breast cancer is one of Pharmac’s Hauora Arotahi Māori health areas of focus. Māori and Pacific people are more likely to get breast cancer and when they do, they are more likely to be diagnosed at a later stage and experience worse outcomes than non-Māori non-Pacific people. Around 15-20% of people with breast cancer are HER2-positive, with similar proportions for Māori. The proportion of people with HER2-positive breast cancer is higher for Pacific people.

Pertuzumab and trastuzumab are already funded as separate IV infusions for people with HER2-positive metastatic breast cancer. In the 2024/25 financial year, around 260 people received this treatment for metastatic breast cancer. Pertuzumab and trastuzumab, when used with docetaxel in this disease setting, helps people live longer and delays the progression of cancer.

Pertuzumab listing(external link)

Trastuzumab listing(external link)

SC pertuzumab with trastuzumab would be given under the supervision of a healthcare professional; people wouldn’t inject themselves. From 1 December 2025, funded SC pertuzumab with trastuzumab would be available through hospital services and would not be available via community pharmacy. It is expected SC pertuzumab with trastuzumab would be given in hospital outpatient services initially (where the IV treatment is currently given). Over time, treatment may be rolled out to centres close to home for people, like community-based infusion centres. We would like to hear from people in the health sector what Pharmac could do to support the accessibility of this combined SC formulation.

Why we’re proposing this

Roche submitted a funding application for Phesgo for metastatic breast cancer in June 2022. In November 2022, PTAC advised it should only be funded if cost neutral to the combined cost of separate IV infusions of pertuzumab and trastuzumab. The Cancer Treatments Advisory Committee (CTAC) reviewed the application in October 2023, and recommended it be funded with a high priority.

You can read more about the advice here:

Application Tracker | Pertuzumab and trastuzumab (SC, as PHESGO)(external link)

We have also received funding applications for Phesgo for other stages of breast cancer, including:

  • Adjuvant treatment of individuals with HER2-positive early breast cancer at high risk of recurrence in combination with chemotherapy - this proposal received a deferral recommendation from our advisors. We are awaiting further evidence before this is application is considered again.  
  • HER2-positive, locally advanced, inflammatory or early-stage breast cancer - neoadjuvant treatment - this proposal is currently ranked on the Options for Investment list. This means that it is something we want to fund when we have available budget. Funding Phesgo for this group remains an option in the future.

Application Tracker | Phesgo for adjuvant treatment of individuals with HER2-positive early breast cancer at high risk of recurrence in combination with chemotherapy(external link)

Application Tracker | Phesgo for breast cancer, HER2-positive, locally advanced, inflammatory or early-stage, neoadjuvant treatment(external link)

Prioritisation: How we decide which medicines need funding first (external link)

Details about our proposal

From 1 December 2025, SC pertuzumab with trastuzumab would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule, as follows:

Chemical Formulation  Brand Pack size Price and subsidy
Pertuzumab with trastuzumab Inj 600 mg with 600 mg, 10 ml vial  Phesgo 1 $7,707.00
Pertuzumab with trastuzumab Inj 1200 mg with 600 mg, 15 ml vial  Phesgo 1 $12,894.00

A confidential rebate would apply to Phesgo that would reduce its net price. Phesgo would have protection from delisting and subsidy reduction until 1 December 2027.

Phesgo would be listed in Section B of the Pharmaceutical Schedule as a ‘PCT only’ pharmaceutical, which means that only Health NZ hospitals would be able to make subsidy claims.

SC pertuzumab with trastuzumab would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule with similar eligibility criteria to the individual medicines, as follows:

Special Authority for Subsidy

Initial application — (metastatic breast cancer) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: 

Either:

  1. Both
    1. The individual has received an initial Special Authority approval for intravenous pertuzumab and trastuzumab for metastatic breast cancer; and
    2. Pertuzumab with trastuzumab to be administered subcutaneously at a maximum dose of 600 mg every three weeks (or equivalent); or
  2. All of the following:
    1. The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology); and
    2. Either:
      1. Patient is chemotherapy treatment naïve; or
      2. Patient has not received prior treatment for their metastatic disease and has had a treatment free interval of at least 12 months between prior (neo)adjuvant chemotherapy treatment and diagnosis of metastatic breast cancer; and
    3. The patient has good performance status (ECOG grade 0-1); and
    4. Both:
      1. Loading dose of pertuzumab with trastuzumab to be administered subcutaneously at a maximum dose of 1200 mg and 600 mg, respectively; and
      2. Maintenance doses of pertuzumab with trastuzumab to be administered subcutaneously at a maximum dose of 600 mg every three weeks (or equivalent); and
    5. Pertuzumab with trastuzumab to be discontinued at disease progression.

Renewal — (metastatic breast cancer) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria:

Either:

  1. Both:
    1. The individual has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology); and
    2. The cancer has not progressed at any time point during the previous 12 months whilst on pertuzumab and trastuzumab; or
  2. All of the following:
    1. Individual has previously discontinued treatment with pertuzumab with trastuzumab for reasons other than severe toxicity or disease progression; and
    2. Individual has signs of disease progression; and
    3. Disease has not progressed during previous treatment with pertuzumab with trastuzumab. 

As a new, funded cancer medicine, eligible people who are receiving (or about to receive) treatment with Phesgo in a private facility as at 1 December 2025 would be able to receive funded treatment in that facility for up to 12 months. More information about transitional access to cancer medicines is available on the Ministry of Health website(external link).

Faricimab for diabetic macular oedema and wet age-related macular degeneration

What would the effect be?

From 1 December 2025, faricimab (Vabysmo) would be funded as an option for people with for diabetic macular oedema and wet age-related macular degeneration who have not received sufficient benefit from treatment with bevacizumab. Faricimab would be funded for use in this second-line setting, alongside aflibercept (Eylea). People starting second-line treatment would be able to choose between faricimab or aflibercept.

For some people, faricimab may be able to be given less frequently than aflibercept, so this may reduce the number of injections people need each year.

We anticipate around 950 people would receive treatment in the first year, increasing to 2,900 each year by year five.

Who may be interested

  • People with eye conditions, their family, whānau and caregivers
  • Health professionals involved in the care of people with eye conditions
  • Groups who support and advocate for people with eye conditions
  • Hospital pharmacies
  • Pharmaceutical suppliers and wholesalers.

About diabetic macular oedema, wet age-related macular degeneration and faricimab (Vabysmo)

Diabetic macular oedema is an advanced and serious eye condition which can result in damage to the eye from high blood sugar caused by diabetes. Diabetic macular oedema is a major cause of vision loss.

Neovascular (wet) age-related macular degeneration is an advanced stage of age-related macular degeneration. It impacts the part of the eye responsible for how clearly someone can see (visual acuity) and colour vision. The condition gradually gets worse over time and can result in permanent vision loss.

Faricimab is injected into the eye by a healthcare professional. It helps to maintain vision and control the disease.

When treatment with faricimab is started, people would receive an injection every month for four months. After that, a “treat and extend” approach may be used, where the time between injections is extended in two-week amounts, to determine how long a person can go between injections without symptoms. The time between injections is different for everyone, but for some people this can become as long as three or four months. Fewer injections would be expected to have a meaningful impact on people receiving treatment, as well as positively impacting their family, who may need to take time off work to help with attending appointments.

Why we’re proposing this

Roche submitted funding applications for faricimab for wet age-related macular degeneration and diabetic macular oedema in August 2023. In February 2024 PTAC advised that faricimab should be funded only if cost neutral to aflibercept. In August 2024 the Ophthalmology Advisory Committee reviewed the application and provided additional advice.  

You can read more about the advice here:

Application Tracker | Faricimab for the second-line treatment of patients with neovascular (wet) age-related macular degeneration(external link)

Application Tracker | Faricimab for the second-line treatment of patients with diabetic macular oedema(external link)

The Ophthalmology Advisory Committee noted it would be helpful to have a treatment option for people with diabetic macular oedema or neovascular (wet) age-related macular degeneration who have not received sufficient benefit from treatment with bevacizumab and aflibercept or faricimab (third-line setting). We would welcome a funding application to assess a third-line treatment option. More detail on the submission of funding applications is available on our website.

Medicine funding application(external link)

Details about our proposal

From 1 December 2025, Vabysmo would be listed on Section B and Part II of Section H of the Pharmaceutical Schedule, as a PCT only medicine, as follows: 

Chemical Formulation Brand Pack size Price and subsidy
Faricimab Inj 120 mg per ml, 0.24 ml vial Vabysmo 1 $1,565.00

A confidential rebate would apply to Vabysmo that would reduce its net price. Vabysmo would have protection until 1 December 2027.

Faricimab would be listed in Section B of the Pharmaceutical Schedule as a ‘PCT only’ pharmaceutical, which means that only Health NZ hospitals would be able to make subsidy claims. This allows Pharmac’s funding of this high cost medicine to be targeted to public hospitals, where it is intended to be given. Pharmac’s proposed funding of faricimab would not allow funded faricimab to be provided in private settings at this time.  

Vabysmo would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule (for the purposes of claiming) subject to the same eligibility criteria as aflibercept:

Special Authority for Subsidy

Initial application — (diabetic macular oedema) from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria: 

All of the following:

  1. Patient has centre involving diabetic macular oedema (DMO); and
  2. Patient’s disease is nonresponsive to 4 doses of intravitreal bevacizumab when administered 4-6 weekly; and
  3. Patient has reduced visual acuity between 6/9 – 6/36 with functional awareness of reduction in vision; and
  4. Patient has DMO within central OCT (ocular coherence tomography) subfield > 350 micrometres; and
  5. There is no centre-involving sub-retinal fibrosis or foveal atrophy; and
  6. Patient has not previously been treated with aflibercept for longer than 3 months

Renewal — (diabetic macular oedema) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: 

All of the following:

  1. There is stability or two lines of Snellen visual acuity gain; and
  2. There is structural improvement on OCT scan (with reduction in intra-retinal cysts, central retinal thickness, and sub-retinal fluid); and
  3. Patient’s vision is 6/36 or better on the Snellen visual acuity score; and
  4. There is no centre-involving sub-retinal fibrosis or foveal atrophy.

Initial application – (wet age related macular degeneration) from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: 

All of the following:

  1. Any of the following:
    1. Wet age-related macular degeneration (wet AMD); or
    2. Polypoidal choroidal vasculopathy; or
    3. Choroidal neovascular membrane from causes other than wet AMD; and
  2. Either:
    1. The patient has developed severe endophthalmitis or severe posterior uveitis following treatment with bevacizumab; or
    2. There is worsening of vision or failure of retina to dry despite three intraocular injections of bevacizumab four weeks apart; and
  3. There is no structural damage to the central fovea of the treated eye; and
  4. Patient has not previously been treated with ranibizumab or aflibercept for longer than 3 months.

Renewal criteria – (wet age related macular degeneration) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: 

Both:

  1. Patient’s vision is 6/36 or better on the Snellen visual acuity score; and
  2. There is no structural damage to the central fovea of the treated eye.

Proposed changes to aflibercept criteria

Aflibercept (Eylea) would continue to be funded as it is now, there would be a small change to the access criteria to reflect the availability of faricimab, as follows (additions in bold, deletions in strikethrough):

Special Authority for Subsidy

Initial application — (diabetic macular oedema) Only from an ophthalmologist from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria: 

All of the following:

  1. Patient has centre involving diabetic macular oedema (DMO); and
  2. Patient’s disease is non responsive to 4 doses of intravitreal bevacizumab when administered 4-6 weekly; and 
  3. Patient has reduced visual acuity between 6/9 – 6/36 with functional awareness of reduction in vision; and
  4. Patient has DMO within central OCT (ocular coherence tomography) subfield > 350 micrometers; and
  5. There is no centre-involving sub-retinal fibrosis or foveal atrophy; and
  6. Patient has not previously been treated with faricimab for longer than 3 months.

Renewal — (diabetic macular oedema) Only from an ophthalmologist from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria:

All of the following:

  1. There is stability or two lines of Snellen visual acuity gain; and
  2. There is structural improvement on OCT scan (with reduction in intra-retinal cysts, central retinal thickness, and sub-retinal fluid); and
  3. Patient’s vision is 6/36 or better on the Snellen visual acuity score; and
  4. There is no centre-involving sub-retinal fibrosis or foveal atrophy; and
  5. After each consecutive 12 months treatment with (2nd line anti-VEGF agent), patient has retrialled with at least one injection of bevacizumab and had no response.

Initial application — (wet age-related macular degeneration) Only from an ophthalmologist from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: 

Either:

  1. All of the following:
    1. Any of the following:
      1. Wet age-related macular degeneration (wet AMD); or
      2. Polypoidal choroidal vasculopathy; or
      3. Choroidal neovascular membrane from causes other than wet AMD; and
    2. Either:
      1. The patient has developed severe endophthalmitis or severe posterior uveitis following treatment with bevacizumab; or
      2. There is worsening of vision or failure of retina to dry despite three intraocular injections of bevacizumab four weeks apart; and
    3. There is no structural damage to the central fovea of the treated eye; and
    4. Patient has not previously been treated with ranibizumab for longer than 3 months; or 
  2. Either:
    1. Patient has current approval to use ranibizumab or faricimab for treatment of wAMD and was found to be intolerant to ranibizumab within 3 months; or
    2. Patient has previously* (*before June 2018) received treatment with ranibizumab for wAMD and disease was stable while on treatment.

Renewal — (wet age-related macular degeneration) Only from an ophthalmologist from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria:

All of the following:

  1. Documented benefit must be demonstrated to continue; and
  2. Patient’s vision is 6/36 or better on the Snellen visual acuity score; and 
  3. There is no structural damage to the central fovea of the treated eye.

Proposed changes to ranibizumab criteria

Similarly, the access criteria for ranibizumab would be updated in Part II of Section H of the Pharmaceutical Schedule from 1 December 2025 (additions in bold, deletions in strikethrough):

Restricted

Initiation – Wet Age-Related Macular Degeneration 

Ophthalmologist or nurse practitioner 

Re-assessment required after 3 months

Either:

  1. All of the following:
    1. Any of the following:
      1. Wet age-related macular degeneration (wet AMD); or
      2. Polypoidal choroidal vasculopathy; or
      3. Choroidal neovascular membrane from causes other than wet AMD; and
    2. Either:
      1. The patient has developed severe endophthalmitis or severe posterior uveitis following treatment with bevacizumab; or
      2. There is worsening of vision or failure of retina to dry despite three intraocular injections of bevacizumab four weeks apart; and
    3. There is no structural damage to the central fovea of the treated eye; and
    4. Patient has not previously been treated with aflibercept or faricimab for longer than 3 months; or
  2. Patient has current approval to use aflibercept or faricimab for treatment of wAMD and was found to be intolerant to aflibercept within 3 months.

Continuation – Wet Age-Related Macular Degeneration

Ophthalmologist or nurse practitioner 

Re-assessment required after 12 months

All of the following:

  1. Documented benefit must be demonstrated to continue; and
  2. Patient’s vision is 6/36 or better on the Snellen visual acuity score; and 
  3. There is no structural damage to the central fovea of the treated eye.

Entrectinib for ROS1-positive, locally advanced or metastatic non-small cell lung cancer

What would the effect be?

From 1 December 2025, entrectinib (branded as Rozlytrek) would be funded for people with ROS1-positive, locally advanced or metastatic non-small cell lung cancer.

This would mean that people could start treatment on either entrectinib or crizotinib.

We estimate that around 11 people would receive entrectinib in the first year of funding, and this would decrease to around four people each year after five years of funding.

Who may be interested

  • People with lung cancer, their family, whānau, friends and caregivers
  • Health professionals involved in the care of people with lung cancer
  • Groups who support and advocate for people with cancer
  • Health NZ | Te Whatu Ora and Te Aho o Te Kahu | The Cancer Control Agency
  • Hei Āhuru Mōwai
  • Pharmacies and wholesalers
  • Pharmaceutical suppliers.

About lung cancer and entrectinib

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. A small number of people with NSCLC have a change in a gene called ROS1, which causes the cancer to grow.

Lung cancer is one of Pharmac’s Hauora Arotahi Māori health areas of focus(external link). NSCLC is a leading cause of the current life expectancy gap between Māori, Pacific people and non-Māori non-Pacific peoples (Health Status Report 2023 | Health NZ(external link)). Māori and Pacific people are diagnosed at a younger age, often presenting with later stage disease and experience worse outcomes from NSCLC than non-Māori, non-Pacific peoples. However, at this time it is not clear whether either Māori or Pacific have different rates of ROS1 mutated NSCLC compared to non-Māori, non-Pacific people.

Entrectinib helps to slow down or stop cancer growing by blocking the signals from abnormal protein that signals cancer cells to multiply. In some cases, it can also shrink the cancer.

Entrectinib is available as a capsule and is taken orally every day.

Why we’re proposing this

Roche submitted a funding application for entrectinib in August 2020. In April 2021 the Cancer Treatments Subcommittee (now Advisory Committee) recommended entrectinib be funded with a high priority within the context of treatments for malignancy. You can read more about the advice here:

Application Tracker | Entrectinib for NSCLC – adult patients with ROS1-positive, locally advanced or metastatic(external link)

Details about our proposal

From 1 December 2025, entrectinib would be listed on Section B and Part II of Section H of the Pharmaceutical Schedule, as follows:

Chemical Formulation Brand Pack size Price and subsidy
Entrectinib Cap 200 mg Rozlytrek 90 $9,610.00

A confidential rebate would apply to Rozlytrek that would reduce its net price.

Entrectinib would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule subject to the following eligibility criteria:

Special Authority for Subsidy

Initial application from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria:

All of the following:

  1. Individual has locally advanced or metastatic, unresectable, non-squamous non-small cell lung cancer; and
  2. Either:
    1. The individual has not received crizotinib; or
    2. Both:
      1. The individual has received an initial Special Authority approval for crizotinib and has discontinued crizotinib within 12 weeks of starting due to intolerance; and
      2. The cancer did not progress while the individual was on crizotinib; and
  3. There is documentation confirming that the patient has a ROS1 rearrangement using an appropriate ROS1 test; and
  4. Individual has ECOG performance score of 0-3; and
  5. Baseline measurement of overall tumour burden is documented clinically and radiologically.

Renewal from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: 

Both:

  1. Response to treatment has been determined by comparable radiological assessment following the most recent treatment period; and
  2. No evidence of disease progression.

Proposed changes to crizotinib criteria

Crizotinib (Xalkori) would continue to be funded as it is now, there would be a small change to the access criteria to reflect the availability of entrectinib, as follows (additions in bold, deletions in strikethrough):

Special Authority for Subsidy

Initial application from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria:

All of the following:

  1. Patient Individual has locally advanced or metastatic, unresectable, non-squamous non-small cell lung cancer; and
  2. Either:
    1. The individual has not received entrectinib; or
    2. Both:
      1. The individual has received an initial Special Authority approval for entrectinib and has discontinued entrectinib within 12 weeks of starting due to intolerance; and
      2. The cancer did not progress while the individual was on entrectinib; and
  3. There is documentation confirming that the patient has a ROS1 rearrangement using an appropriate ROS1 test; and
  4. Patient Individual has ECOG performance score of 0-3; and
  5. Baseline measurement of overall tumour burden is documented clinically and radiologically.

Renewal from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: 

Both:

  1. Response to treatment has been determined by comparable radiological assessment following the most recent treatment period; and
  2. No evidence of disease progression.

Bevacizumab (Avastin) for eye conditions

What would the effect be?

Bevacizumab of any brand is currently funded for the first-line treatment of the eye conditions ocular neovascularisation and exudative ocular angiopathy. We understand that currently in New Zealand only the Avastin brand is used. This proposal would secure ongoing supply of Avastin for these uses. The access criteria would remain the same.

The biosimilar brand of bevacizumab, Vegzelma, would also continue to be funded for ocular conditions if people wish to use it. Prescribers and their patients could continue to choose which brand to use for ocular conditions.

Vegzelma would continue to be the only funded brand for ovarian cancer, liver cancer and recurrent respiratory papillomatosis.

Who may be interested

  • People with eye conditions, their family, whānau and caregivers
  • Health professionals involved in the care of people with eye conditions
  • Groups who support and advocate for people with eye conditions
  • Hospital pharmacies
  • Pharmaceutical suppliers and wholesalers.

Why we’re proposing this

In February 2025, we announced a contract for the Vegzelma brand of bevacizumab. Based on the evidence at the time, our advisors told us it would not be clinically appropriate for people receiving bevacizumab for eye conditions to receive a biosimilar bevacizumab. Because of this we maintained funding for “any brand” of bevacizumab, so funding would continue for the Avastin brand.

This proposal would secure the ongoing supply of Avastin to make sure it is available for New Zealanders who need it.

Details about our proposal

From 1 December 2025, the following listing would change from “any brand” to “Avastin” on Part II of Section H of the Pharmaceutical Schedule, as follows: 

Chemical Formulation Brand Pack size Price and subsidy
Bevacizumab (ocular) Inj 25 mg per ml, 4 ml vial Avastin 1 $600.00

A confidential rebate would apply to Avastin that would reduce its net price. Avastin would have protection from delisting and subsidy reduction until 1 December 2028. The eligibility criteria for Avastin in Part II of Section H of the Pharmaceutical Schedule would remain as it is now.

The inj 25 mg per ml, 16 ml bevacizumab (ocular) formulation listing on Part II of Section H would remain “any brand”.

Pharmac currently has a Principal Supply Status contract for the Vegzelma brand of bevacizumab. Use of Avastin for eye conditions would be managed under the Alternative Brand Allowance. Vegzelma is funded as a PCT only medicine and Health NZ hospitals can claim for it accordingly. Avastin would not be funded PCT.

Decision to fund medicines for liver and ovarian cancers, and to award Principal Supply Status for bevacizumab to Vegzelma(external link)

Obinutuzumab (Gazyva) for currently funded conditions  

As part of this proposal, we are proposing to widen the types of applicants who can apply for funded obinutuzumab for the treatment of chronic lymphocytic leukaemia and follicular / marginal zone lymphoma. This may make access easier for some people. From 1 December 2025, the following changes would be made to the eligibility criteria. Additions in bold, deletions in strikethrough:   

Special Authority for Subsidy

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

All of the following:

  1. The patient has progressive Binet stage A, B or C CD20+ chronic lymphocytic leukaemia requiring treatment; and
  2. The patient is obinutuzumab treatment naive; and
  3. The patient is not eligible for full dose FCR due to comorbidities with a score > 6 on the Cumulative Illness Rating Scale (CIRS) or reduced renal function (creatinine clearance < 70mL/min); and
  4. Patient has adequate neutrophil and platelet counts* unless the cytopenias are a consequence of marrow infiltration by CLL; and
  5. Patient has good performance status; and
  6. Obinutuzumab to be administered at a maximum cumulative dose of 8,000 mg and in combination with chlorambucil for a maximum of 6 cycles.

Notes: Chronic lymphocytic leukaemia includes small lymphocytic lymphoma. Comorbidity refers only to illness/impairment other than CLL induced illness/impairment in the patient. '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 obinutuzumab is expected to improve symptoms and improve ECOG score to < 2.

* Neutrophil greater than or equal to 1.5 × 109/L and platelets greater than or equal to 75 × 109/L.

Initial application — (follicular / marginal zone lymphoma) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist from any relevant practitioner. Approvals valid for 9 months for applications meeting the following criteria:

All of the following:

  1. Either:
    1. Patient has follicular lymphoma; or
    2. Patient has marginal zone lymphoma; and
  2. Patient is refractory to or has relapsed within 12 months of a rituximab containing combined chemo-immunotherapy regimen*; and
  3. Patient has an ECOG performance status of 0-2; and
  4. Patient has been previously treated with no more than four chemotherapy regimens; and
  5. Obinutuzumab to be administered at a maximum dose of 1000 mg for a maximum of 6 cycles in combination with chemotherapy*.

Note: * includes unapproved indications

Renewal — (follicular / marginal zone lymphoma) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist from any relevant practitioner. Approvals valid for 24 months for applications meeting the following criteria: 

All of the following:

  1. Patient has no evidence of disease progression following obinutuzumab induction therapy; and
  2. Obinutuzumab to be administered at a maximum of 1000 mg every 2 months for a maximum of 2 years; and 
  3. Obinutuzumab to be discontinued at disease progression.

Rituximab for rheumatoid arthritis

As part of this proposal, we are proposing to widen the types of applicants who can apply for the funded Mabthera brand of rituximab for the treatment of rheumatoid arthritis. This may make access easier for some people. From 1 December 2025 the following changes would be made to the access criteria. Additions in bold, deletions in strikethrough:  

Special Authority for Subsidy

Initial application - (rheumatoid arthritis - TNF inhibitors contraindicated) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria: 

All of the following:

  1. Treatment with a Tumour Necrosis Factor alpha inhibitor is contraindicated; and
  2. Patient has had severe and active erosive rheumatoid arthritis (either confirmed by radiology imaging, or the patient is cyclic citrullinated peptide (CCP) antibody positive) for six months duration or longer; and
  3. Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and
  4. Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with sulfasalazine and hydroxychloroquine sulphate (at maximum tolerated doses); and
  5. Any of the following:
    1. Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with the maximum tolerated dose of ciclosporin; or
    2. Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with intramuscular gold; or
    3. Patient has tried and not responded to at least three months of therapy at the maximum tolerated dose of leflunomide alone or in combination with oral or parenteral methotrexate; and
  6. Either:
    1. Patient has persistent symptoms of poorly controlled and active disease in at least 20 swollen, tender joints; or
    2. Patient has persistent symptoms of poorly controlled and active disease in at least four joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and
  7. Either:
    1. Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or
    2. C-reactive protein levels not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months; and
  8. Either:
    1. Rituximab to be used as an adjunct to methotrexate or leflunomide therapy; or
    2. Patient is contraindicated to both methotrexate and leflunomide, requiring rituximab monotherapy to be used; and
  9. Maximum of two 1,000 mg infusions of rituximab given two weeks apart.

Initial application — (rheumatoid arthritis - prior TNF inhibitor use) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria:

All of the following:

  1. Both:
    1. The patient has had an initial community Special Authority approval for at least one of etanercept and/or adalimumab for rheumatoid arthritis; and
    2. Either:
      1. The patient has experienced intolerable side effects from a reasonable trial of adalimumab and/or etanercept; or
      2. Following at least a four month trial of adalimumab and/or etanercept, the patient did not meet the renewal criteria for adalimumab and/or etanercept for rheumatoid arthritis; and
  2. Either:
    1. Rituximab to be used as an adjunct to methotrexate or leflunomide therapy; or
    2. Patient is contraindicated to both methotrexate and leflunomide, requiring rituximab monotherapy to be used; and
  3. Maximum of two 1,000 mg infusions of rituximab given two weeks apart.

Renewal — (rheumatoid arthritis - re-treatment in 'partial responders' to rituximab) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria:

All of the following:

  1. Any of the following:
    1. At 4 months following the initial course of rituximab infusions the patient had between a 30% and 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or
    2. At 4 months following the second course of rituximab infusions the patient had at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or
    3. At 4 months following the third and subsequent courses of rituximab infusions, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; and
  2. Rituximab re-treatment not to be given within 6 months of the previous course of treatment; and
  3. Either:
    1. Rituximab to be used as an adjunct to methotrexate or leflunomide therapy; or
    2. Patient is contraindicated to both methotrexate and leflunomide, requiring rituximab monotherapy to be used; and
  4. Maximum of two 1,000 mg infusions of rituximab given two weeks apart.

Renewal — (rheumatoid arthritis - re-treatment in 'responders' to rituximab) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria: 

All of the following:

  1. Either:
    1. At 4 months following the initial course of rituximab infusions the patient had at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or
    2. At 4 months following the second and subsequent courses of rituximab infusions, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; and
  2. Rituximab re-treatment not to be given within 6 months of the previous course of treatment; and
  3. Either:
    1. Rituximab to be used as an adjunct to methotrexate or leflunomide therapy; or
    2. Patient is contraindicated to both methotrexate and leflunomide, requiring rituximab monotherapy to be used; and
  4. Maximum of two 1,000 mg infusions of rituximab given two weeks apart. 

Other changes

As part of this proposal, there would also be changes to contract arrangements, including confidential rebates, for some currently funded medicines supplied by Roche. These include:

  • Obinutuzumab (Gazyva)
  • Rituximab (Mabthera), and
  • The IV formulation of ocrelizumab (Ocrevus)

No changes to funding for these medicines would occur. Ocrevus has delisting and subsidy reduction protection until 1 October 2026.

The list price of Ocrevus would change from 1 December 2025 in Section B and Part II of Section H of the Pharmaceutical Schedule, as follows:

Chemical Formulation Brand Park size  Current price and subsidy New price and subsidy
Ocrelizumab Inj 30 mg per ml, 10 ml vial Ocrevus 1 $9,346.00 $8,450.00

Price support for ocrelizumab IV (Ocrevus) would be in place for wholesalers.

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