Updating the Pharmaceutical Schedule for ambulance medicines, and tenecteplase for pre-hospital use

12 March 2026

Medicines Consultation Closes 02 Apr

What we’re proposing

Ambulance medicines

From 1 July 2026, Pharmac will take over responsibility for funding medicines used in ambulances. This change means ambulance medicines would be brought under our existing Schedule arrangements, with some additional listings added to support emergency ambulance services.

We would like your feedback on these proposed changes to the Pharmaceutical Schedule.

Tenecteplase for pre-hospital use

Under this proposal, we would also fund tenecteplase for use within emergency ambulance services and Primary Response in Medical Emergencies (PRIME) services.

Giving feedback

Consultation closes at 5pm on 2 April 2026. You can provide feedback by emailing consult@pharmac.govt.nz or use the online form.

Complete the online form

What would the effect be?

Bringing ambulance medicines into the Pharmaceutical Schedule will help to ensure a more coordinated approach to funding and procurement decisions for emergency medicines, whether they are used in hospitals, ambulances or by PRIME providers.

Under this proposal:

We would create a new section of the Pharmaceutical Schedule (Section E), which would list all medicines that are funded for use by emergency ambulance services.
This list would let ambulance service providers and other stakeholders clearly see everything that is funded for ambulance use.
Ambulance service providers would only be able to order from the list of medicines specified in Section E.
Ambulance service providers would largely continue to order medicines using their existing supply chain arrangements.
We would make changes to the Pharmaceutical Schedule rules and any restrictions on individual products to enable these changes.

Under this proposal, and following feedback from our recent proposal to fund treatments in the community for trauma and medical emergencies, we would also fund tenecteplase for use within PRIME and emergency ambulance services.

Decision to fund treatments in the community for trauma and medical emergencies, and ketamine for palliative care

Who we think will be interested

Ambulance service providers
PRIME providers
Paramedics and healthcare practitioners providing emergency care
Pharmacists
Healthcare professional representative groups
Organisations supporting emergency medicine practitioners
Health New Zealand, including Sector Operations, ACC
Suppliers and wholesalers

About our proposal

Ambulance medicines funding

Pharmac is the main funder of medicines across the public health sector, but ambulance medicines have historically been funded differently. From 1 July 2026 Pharmac will be responsible for funding ambulance medicines, and ambulance medicines would be folded into the Pharmaceutical Schedule.

Currently, Health NZ and ACC jointly fund emergency road and air ambulance services, and ambulance providers use this funding to purchase the medicines they need.

Ambulance service providers purchase medicines from multiple sources, including pharmaceutical suppliers, pharmaceutical wholesalers and community pharmacies. They also source stock of some medicines such as tenecteplase directly from Health NZ hospitals.

Health NZ and ACC are re-contracting for emergency road ambulance services from July 2026, which has provided an opportunity to implement a change in responsibility for ambulance medicines funding, and we have been working closely with our sector partners on this change.

Tenecteplase for pre-hospital care

Tenecteplase (in conjunction with other funded medicines) is used for the treatment of ST-elevation myocardial infarction (STEMI), a type of heart attack. Tenecteplase should be given as early as possible. Patient outcomes can be improved if it is used by PRIME and emergency ambulance services prior to hospital care.

What’s not changing

Under this proposal:

Ambulance medicines that are currently funded would remain funded and available.
Ambulance service providers would largely continue to order medicines as they do now.
Consumers would not see any change in emergency ambulance services.

Why we’re proposing changes to the Pharmaceutical Schedule

To incorporate ambulance medicines into our existing arrangements in a clear and consistent way, we propose creating a new section of the Schedule: Section E. This section would list the medicines used in emergency ambulance settings and outline the specific rules that apply to emergency ambulance services.

We have been working closely with ambulance service providers to understand the medicines and nuance of the medicines presentations they are currently using for emergency road and air ambulance services.

What you need to know about our proposal

Ambulance service providers currently buy most of their medicines in original packs from wholesalers. Sometimes they require smaller quantities of some medicines for a range of reasons, which are sourced from community pharmacies. This proposal puts arrangements in place to support this.

For ambulance service providers

Ambulance service providers would largely continue to order medicines as they do now. Section E would indicate which products should be ordered from a wholesaler, or from community pharmacy.

Ambulance service providers would not pay for medicines, whether ordered from a community pharmacy or wholesaler.

All ambulance medicines would be listed in Section E of the Pharmaceutical Schedule.

Listing ambulance medicines on the Schedule removes the need to source stock from Health NZ hospitals and allows medicines like tenecteplase to be ordered directly from wholesalers.

For community pharmacists

All ambulance medicines listed in Section E of the Pharmaceutical Schedule that require repacking for ambulance service use would also be listed in Section B.

Community pharmacists would be able to claim for repacking of medicines into smaller lots, and distribution / service costs as a Bulk Supply Order (BSO) under the current terms of the Integrated Community Pharmacy Service Agreement (ICPSA)(external link)

For wholesalers

Health NZ is leading changes to allow wholesalers to be reimbursed for the ambulance medicine costs and distribution costs (under a wholesale claiming agreement with Health NZ).

Where Pharmac already funds an ambulance medicine in Section B or Section H of the Pharmaceutical Schedule, that subsidy would be applied in Section E.
Any medicine subject to a part charge in Section B would be fully subsidised in Section E.
For any ambulance medicine not currently funded by Pharmac, the subsidy would be the same as the list price.

Tenecteplase for pre-hospital use

Tenecteplase is currently provided directly to PRIME providers and ambulance service providers from Health NZ hospitals.

Under this proposal, tenecteplase would be funded on Section B of the Pharmaceutical Schedule when supplied on a Practitioner Supply Order (PSO) with an endorsement for use for PRIME services. This means that PRIME providers would be able to order tenecteplase from community pharmacies on a PSO, consistent with arrangements for the supply of other PRIME medicines.

Tenecteplase would also be funded on Section E of the Pharmaceutical Schedule for use by ambulance service providers who would order directly from wholesalers.

Changes to Pharmaceutical Schedule

Summary of proposed changes

We need to make some changes to the Pharmaceutical Schedule to:

Ensure a complete list of funded ambulance medicines is easily available (Section E).
Allow ambulance service providers to order funded medicines from community pharmacies using a Bulk Supply Order (BSO).
Ensure that any funding restrictions in Section B of the Schedule accommodate supply to ambulance services by community pharmacies.
Enable tenecteplase to be funded for Primary Use in Medical Emergency Services (PRIME) and also for emergency ambulance services.

Details about our changes

The Rules of the Pharmaceutical Schedule would be updated from 1 July 2026 as follows (additions in bold, deletions in strikethrough). Only relevant parts of rules with proposed changes are shown.

Part 1 – Prescribing and initiating Subsidies for Community Pharmaceuticals

1.1.6 Ambulance Service Providers for Pharmaceuticals listed in Section E of the Schedule only.

1.3.5 Bulk Supply Orders (BSO): For Pharmaceuticals to be Subsidised on a BSO, the BSO must be:

a for supply of Community Pharmaceuticals to:

i either Private Hospitals that employ a Registered Nurse, for the treatment of people under the care of that facility, or

ii to a Vaccinator for medicines that are part of an approved immunisation programme and only where specifically indicated in Section B of the Schedule, or

iii Ambulance Service Providers and only where specifically indicated for a Pharmaceutical in Section E of the Schedule.

b be on a form supplied or approved by the Ministry of Health and signed by:

i either a Hospital Care Operator, or

ii a Vaccinator for medicines that are part of an approved immunisation programme and only where specifically indicated in Section B of the Schedule, or

iii an authorised representative of an Ambulance Service Provider and only where specifically indicated for a Pharmaceutical in Section E of the Schedule.

c for a Class B Controlled Drug or for buprenorphine hydrochloride, be written on a triplicate BSO Controlled Drug Form supplied by the Ministry of Health.

d not exceed what is a reasonable Monthly allocation for the particular institution, Ambulance Service Provider or Vaccinator’s circumstances of use

e meet all the Subsidy requirements of Section B or Section E of the Schedule applicable to that Community Pharmaceutical, and

Part 6 – Funding

6.1 Subsidies for Community Pharmaceuticals

6.1.3 Where the Subsidy specified in Section E differs from the Subsidy in other sections of the Schedule for a Community Pharmaceutical, the Subsidy in Section E will apply to a Community Pharmaceutical for Ambulance Service Providers only.

Part 10 – Definitions

Ambulance Service Provider means an organisation that is contracted by Health New Zealand to deliver emergency trauma and medical care

Community Pharmaceutical means a Pharmaceutical listed in Sections B to D E or I of the Schedule that is eligible for a Subsidy.

Section E of the Pharmaceutical Schedule

All pharmaceuticals under this proposal would be listed in Section E of the Pharmaceutical Schedule from 1 July 2026, as shown below.

Section E describes the arrangements for community pharmaceutical subsidies when these medicines are supplied to emergency ambulance service providers.

Section E sets out:

All ambulance medicines, including presentation, strength, pack size and brand that would be funded when ordered by ambulance service providers.
Where each medicine should be ordered from, for example wholesalers or community pharmacists.
Information to help ambulance service providers interpret Section E.
Line items for ambulance medicines which would be subject to wholesaler reimbursement for medicine and distribution costs (under a wholesale claiming agreement with Health NZ).

Medicines which require packing in to smaller quantities

Section E sets out the pack size that should be ordered from wholesalers.

Section E also indicates the medicines that ambulance service providers can order in smaller quantities. These items should be ordered from any community pharmacy using a Bulk Supply Order (BSO). Health NZ provide details on how to obtain BSO forms (Health NZ website)(external link).

Download the list as an XLSX spreadsheet

2026 03 09 Proposed Section E medicines [XLSX 26 KB]

View the full list of proposed Section E medicines

Number	Chemical	Presentation	Price & subsidy	Pack size	Brand	Wholesale/Pharmacy
1	Adenosine	Inj 3 mg per ml, 2 ml vial	34.50	per 5	Adsine	W
2	Adenosine	Inj 3 mg per ml, 10 ml vial	100.00	per 5	Adenosine Baxter	W
3	Adrenaline	Inj 1 in 1,000, 1 ml ampoule	17.78	per 5	DBL Adrenaline	W
4	Adrenaline	Inj 1 in 1,000, 1 ml ampoule	4.98	per 5	Aspen Adrenaline	W
5	Adrenaline	Inj 1 in 10,000, 10 ml ampoule	36.18	per 5	Hospira	W
6	Adrenaline	Inj 1 in 10,000, 10 ml ampoule	49.00	per 10	Aspen Adrenaline	W
7	Aminophylline	Inj 25 mg per ml, 10 ml ampoule	180.00	per 5	DBL Aminophylline	W
8	Amiodarone hydrochloride	Inj 50 mg per ml, 3 ml ampoule	17.96	per 10	Max Health	W
9	Amlodipine	Tab 5 mg	1.21	per 90	Vasorex	W or P
10	Amoxicillin	Cap 500 mg	1.14	per 20	Amoxycillin Sandoz	W or P
11	Amoxicillin	Grans for oral liq 250 mg per 5 ml	2.81	per 100 ml	Alphamox 250	W
12	Amoxicillin with clavulanic acid	Tab 500 mg with clavulanic acid 125 mg	1.59	per 10	Curam Duo 500/125	W or P
13	Amoxicillin with clavulanic acid	Grans for oral liq amoxicillin 25 mg with clavulanic acid 6.25 mg per ml	8.50	per 100 ml	Augmentin	W
14	Amoxicillin with clavulanic acid	Grans for oral liq amoxicillin 50 mg with clavulanic acid 12.5 mg per ml	5.61	per 100 ml OP	Amoxiclav Devatis Forte	W
15	Amoxicillin with clavulanic acid	Inj 1,000 mg with clavulanic acid 200 mg vial	26.9	per 10	Cerobact	W
16	Amoxicillin with clavulanic acid	Inj 1,000 mg with clavulanic acid 200 mg vial	29.61	per 11	Synermox	W
17	Articaine hydrochloride with adrenaline	Inj 4% with adrenaline 1:100,000, 2.2 ml dental cartridge	54	per 50	Septanest	W
18	Aspirin	Tab dispersible 300 mg	5.65	per 100	Ethics Aspirin	W
19	Atropine sulphate	Inj 600 mcg per ml, 1 ml ampoule	16.10	per 10	Martindale	W
20	Azithromycin	Tab 500 mg	2.80	per 2	Zithromax	W
21	Benzathine benzylpenicillin	Inj 900 mg (1.2 million units) in 2.3 ml syringe	432.37	per 10	Bicillin LA	W
22	Bisacodyl	Suppos 10 mg	4.14	per 10	Lax-Suppositories	W
23	Budesonide with eformoterol	Powder for inhalation 200 mcg with eformoterol fumarate 6 mcg	33.74	per 120 dose OP	Symbicort Turbuhaler 200/6	W
24	Calcium chloride	Inj 100 mg per ml, 10 ml vial	82.68	per 10	Phebra	W
25	Cefalexin	Cap 500 mg	3.33	per 20	Cefalexin Sandoz	W or P
26	Cefalexin	Grans for oral liq 50 mg per ml	11.75	per 100 ml	Cefalexin Sandoz	W
27	Cefalexin	Grans for oral liq 50 mg per ml	10.38	per 100 ml	Flynn	W
28	Cefazolin	Inj 1 g vial	3.59	per 5	Cefazolin-AFT	W
29	Ceftriaxone	Inj 1 g vial	3.49	per 5	Ceftriaxone-AFT	W
30	Ceftriaxone	Inj 2 g vial	8.15	per 5	Ceftriaxone-AFT	W
31	Chloramphenicol	Eye oint 1%	1.55	per 5 g OP	Devatis	W
32	Clopidogrel	Tab 75 mg	5.07	per 84	Arrow - Clopid	W or P
33	Codeine phosphate	Tab 30 mg	6.88	per 100	Noumed	W or P
34	Compound electrolytes with glucose [Dextrose]	Powder for oral soln	8.46	per 10	Enerlyte	W
35	Cyclizine lactate	Inj 50 mg per ml, 1 ml ampoule	16.36	per 10	Hameln	W
36	Dexamethasone	Inj 4 mg per ml, 1 ml ampoule	6.88	per 10	Dexamethasone Medsurge	W
37	Dexamethasone	Inj 4 mg per ml, 2 ml ampoule	10.98	per 10	Dexamethasone Medsurge	W
38	Docusate sodium with sennosides	Tab 50 mg with sennosides 8 mg	1.50	per 100	Solax	W or P
39	Doxycycline	Tab 100 mg	64.43	per 500	Doxine	W or P
40	Droperidol	Inj 2.5 mg per ml, 1 ml ampoule	28.68	per 10	Droperidol Medsurge	W
41	Enoxaparin sodium	Inj 100 mg in 1 ml syringe	70.91	per 10	Clexane	W
42	Erythromycin ethyl succinate	Tab 400 mg	35.82	per 100	E-Mycin	W or P
43	Erythromycin ethyl succinate	Grans for oral liq 200 mg per 5 ml	6.53	per 100 ml	E-Mycin	W
44	Erythromycin ethyl succinate	Grans for oral liq 400 mg per 5 ml	9.41	per 100 ml	E-Mycin	W
45	Fentanyl	Inj 50 mcg per ml, 2 ml ampoule	4.25	per 10	Boucher and Muir	W
46	Fentanyl	Inj 50 mcg per ml, 10 ml ampoule	9.41	per 10	Boucher and Muir	W
47	Fexofenadine hydrochloride	Tab 120 mg	3.49	per 30	Fexaclear	W
48	Flucloxacillin	Cap 500 mg	72.71	per 500	Staphlex	W or P
49	Flucloxacillin	Grans for oral liq 50 mg per ml	5.89	per 100 ml	AFT	W
50	Fluconazole	Inj 2 mg per ml, 50 ml vial	11.20	per 1	Fluconazole-Baxter	W
51	Fluocortolone caproate with fluocortolone pivalate and cinchocaine	Oint 950 mcg, with fluocortolone pivalate 920 mcg, and cinchocaine hydrochloride 5 mg per g	13.05	30g OP	Ultraproct	W
52	Fluorescein sodium with lignocaine hydrochloride	Eye drops 0.25% with lignocaine hydrochloride 4%, single dose	75.46	per 20	Minims Lignocaine Hydrochloride and Fluorescein Sodium, Toumac	W
53	Gentamicin sulphate	Inj 40 mg per ml, 2 ml ampoule	18.38	per 10	Pfizer	W
54	Glucagon hydrochloride	Inj 1 mg syringe kit	32.00	per 1	Glucagon Hypokit	W
55	Glucose [Dextrose]	Oral soln 15 g per 80 ml sachet	70.00	per 50	HypoPak Glucose	W or P
56	Glucose [Dextrose]	Inj 10%, 500 ml bag	126.00	per 18	Baxter Glucose 10%	W
57	Glucose [Dextrose]	Inj 5%, 100 ml bag	97.00	per 50	Fresenius Kabi	W
58	Glucose with sucrose with fructose	Gel 19.7% with sucrose 35% and fructose 19.7%, 18 g sachet	16.45	per 12	Hypo-Fit Energy Orange Sachet	W
59	Glyceryl trinitrate	Patch 50 mg, 10 mg per day	18.62	per 30	Nitroderm TTS	W
60	Glyceryl trinitrate	Oral pump spray, 400 mcg per dose	7.48	per 250 dose OP	Nitrolingual Pump Spray	W
61	Glyceryl trinitrate	Inj 5 mg per ml, 10 ml ampoule	118.00	per 5	Hospira	W
62	Heparin	Inj 5,000 iu per ml, 1ml	70.33	per 5	Hospira	W
63	Hydralazine	Inj 20 mg ampoule	25.90	per 5	Apresoline	W
64	Hydrocortisone	Inj 100 mg vial	3.96	per 1	Solu-Cortef	W
65	Hydrocortisone with miconazole	Crm 1% with miconazole nitrate 2%	2.85	per 15 g OP	Micreme H	W
66	Hyoscine butylbromide	Inj 20mg, 1 ml ampoule	1.91	per 5	Spazmol	W
67	Ibuprofen	Tab 200 mg	21.40	per 1000	Relieve	W or P
68	Ibuprofen	Oral liq 20 mg per ml	2.85	per 200 ml	Ethics	W
69	Ipratropium bromide	Nebuliser soln, 250 mcg per ml, 2 ml ampoule	11.73	per 20	Univent	W
70	Ketamine	Inj 10 mg per ml, 10 ml syringe	76.00	per 5	Biomed	W
71	Ketamine	Inj 100 mg per ml, 2 ml vial	91.98	per 5	Ketalar	W
72	Labetalol	Inj 5 mg per ml, 20 ml ampoule	88.6	per 5	Trandate	W
73	Levetiracetam	Inj 100 mg per ml, 5 ml vial	38.95	per 10	Levetiracetam-AFT	W
74	Levomepromazine hydrochloride	Inj 25 mg per ml, 1 ml ampoule	23.26	per 10	Wockhardt	W
75	Levonorgestrel	Tab 1.5 mg	1.31	per 1	Levonorgestrel -1 (Lupin)	W
76	Lidocaine [Lignocaine]	Spray 10%	82.90	per 50 ml	Xylocaine	W
77	Lidocaine [Lignocaine]	Inj 1%, 5 ml ampoule	35	per 50	Xylocaine	W
78	Lidocaine [Lignocaine]	Inj 1%, 5 ml ampoule	15.00	per 25	Lidocaine-Baxter	W
79	Lidocaine [Lignocaine]	Gel 2%, 11 ml urethral syringe	65.45	per 10	Instillagel Lido	W
80	Lidocaine [Lignocaine] hydrochloride with adrenaline	Inj 1% with adrenaline 1:100,000, 5 ml ampoule	32.00	per 10	Xylocaine	W
81	Lidocaine [Lignocaine] hydrochloride with phenylephrine hydrochloride	Nasal spray 5% with phenylephrine hydrochloride 0.5%	65.00	per 50ml	Entop Plus	W
82	Loperamide hydrochloride	Tab 2 mg	10.75	per 400	Nodia	W or P
83	Loperamide hydrochloride	Cap 2 mg	12.00	per 400	Diamide Relief	W or P
84	Loratadine	Tab 10 mg	1.59	per 100	Loratadine Noumed	W or P
85	Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride	Powder for oral soln 13.125 g with potassium chloride 46.6 mg, sodium bicarbonate 178.5 mg and sodium chloride 350.7 mg	12.19	per 30	Movicol	W or P
86	Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride	Powder for oral soln 13.125 g with potassium chloride 46.6 mg, sodium bicarbonate 178.5 mg and sodium chloride 350.7 mg	10.15	per 30	Molaxole	W or P
87	Magnesium sulphate	Inj 2 mmol per ml, 5 ml ampoule	37.53	per 10	Martindale	W
88	Metaraminol	Inj 10 mg per ml, 1 ml ampoule	53.00	per 10	Torbay	W
89	Metaraminol	Inj 1 mg per ml, 10 ml syringe	21.00	per 5	Biomed	W
90	Methoxyflurane	Soln for inhalation 999.9 mg per g, 3 ml bottle with inhaler device and activated carbon chamber	54.00	1 OP	Penthrox	W
91	Methoxyflurane	Soln for inhalation 999.9 mg per g, 3 ml bottle	276.00	per 10	Penthrox	W
92	Metoclopramide hydrochloride	Tab 10 mg	1.57	per 100	Metoclopramide Actavis 10	W or P
93	Metoclopramide hydrochloride	Inj 5 mg per ml, 2 ml ampoule	5.48	per 10	Medsurge	W
94	Metoprolol succinate	Tab long-acting 47.5 mg	3.65	per 90	Myloc CR	W or P
95	Metoprolol tartrate	Tab 50 mg	5.66	per 100	IPCA-Metoprolol	W or P
96	Metoprolol tartrate	Inj 1 mg per ml, 5 ml vial	26.50	per 5	Metoprolol IV Mylan	W
97	Metoprolol tartrate	Inj 1 mg per ml, 5 ml vial	26.50	per 5	Metoprolol IV Viatris	W
98	Metronidazole	Tab 200 mg	25.86	per 250	Metronidamed	W or P
99	Midazolam	Inj 1 mg per ml, 5 ml ampoule	7.80	per 10	Midazolam-Baxter	W
100	Midazolam	Inj 1 mg per ml, 5 ml plastic ampoule	46.65	per 10	Midazolam-Pfizer	W
101	Midazolam	Inj 1 mg per ml, 5 ml syringe	1.08	per 1	Biomed	W
102	Midazolam	Inj 5 mg per ml, 3 ml ampoule	4.75	per 5	Midazolam-Baxter	W
103	Midazolam	Inj 5 mg per ml, 3 ml plastic ampoule	35.1	per 5	Midazolam-Pfizer	W
104	Morphine sulphate	Inj 10 mg per ml, 1 ml ampoule	4.99	per 5	Medsurge	W
105	Naloxone hydrochloride	Inj 400 mcg per ml, 1 ml ampoule	13.29	per 5	DBL Naloxone Hydrochloride	W
106	Nitrofurantoin	Tab 50 mg	22.20	per 100	Nifuran	W or P
107	Nitrofurantoin	Cap modified-release 100 mg	81.20	per 100	Macrobid	W or P
108	Olanzapine	Tab 2.5 mg	1.40	per 30	Zypine	W
109	Olanzapine	Tab 5 mg	1.93	per 30	Zypine	W
110	Olanzapine	Tab orodispersible 5 mg	2.42	per 28	Zypine ODT	W
111	Olanzapine	Tab 10 mg	1.80	per 28	Zypine	W
112	Olanzapine	Tab 10 mg	1.93	per 30	Zypine	W
113	Ondansetron	Tab 4 mg	1.95	per 50	Periset	W or P
114	Ondansetron	Tab disp 4 mg	0.56	per 10	Periset ODT	W
115	Ondansetron	Tab 8 mg	3.50	per 50	Periset	W or P
116	Ondansetron	Tab disp 8 mg	0.90	per 10	Periset ODT	W
117	Ondansetron	Inj 2 mg per ml, 2 ml ampoule	1.54	per 5	Ondansetron-AFT	W
118	Ondansetron	Inj 2 mg per ml, 4 ml ampoule	2.14	per 5	Ondansetron-AFT	W
119	Oxycodone hydrochloride	Tab controlled-release 10 mg	2.49	per 20	Oxycodone Sandoz	W
120	Oxytocin	Inj 10 iu per ml, 1 ml ampoule	7.18	per 5	Oxytocin BNM	W
121	Oxytocin with ergometrine maleate	Inj 5 iu with ergometrine maleate 500 mcg per ml, 1 ml ampoule	41.47	per 5	Syntometrine	W
122	Paracetamol	Tab 500 mg - blister pack	19.75	per 1000	Pacimol	W
123	Paracetamol	Tab 500 mg - blister pack	1.25	per 20	Ethics	W
124	Paracetamol	Oral liq 250 mg per 5 ml	3.18	per 200 ml	Pamol	W
125	Paracetamol	Inj 10 mg per ml, 100 ml vial	15.30	per 10	Paracetamol Kabi	W
126	Paracetamol	Inj 10 mg per ml, 100 ml bag	6.00	per 20	Paracetamol Kabi	W
127	Parecoxib	Inj 40 mg vial	46.00	per 10	Dynastat	W
128	Prednisolone	Oral liq 5 mg per ml	6.00	per 30 ml OP	Redipred	W
129	Prednisone	Tab 20 mg	50.51	per 500	Prednisone Clinect	W or P
130	Pregabalin	Cap 75 mg	2.65	per 56	Pregabalin Pfizer	W or P
131	Pregabalin	Cap 75 mg	2.65	per 56	Lyrica	W or P
132	Prochlorperazine	Tab 5 mg	25.00	per 250	Nausafix	W or P
133	Prochlorperazine	Inj 12.5 mg per ml, 1 ml	25.81	per 10	Stemetil	W
134	Promethazine hydrochloride	Tab 25 mg	2.69	per 100	Allersoothe	W
135	Promethazine hydrochloride	Inj 25 mg per ml, 2 ml ampoule	21.09	per 5	Hospira	W
136	Propofol	Inj 10 mg per ml, 20 ml ampoule	5.75	per 5	Fresofol 1% MCT/LCT	W
137	Propofol	Inj 10 mg per ml, 50 ml vial	27.5	per 10	Fresofol 1% MCT/LCT	W
138	Rocuronium bromide	Inj 10 mg per ml, 5 ml vial	28.96	per 10	Medsurge	W
139	Ropivacaine hydrochloride	Inj 7.5 mg per ml, 10 ml ampoule	11.00	per 5	Ropivacaine Kabi	W
140	Ropivacaine hydrochloride	Inj 7.5 mg per ml, 20 ml ampoule	13.50	per 5	Ropivacaine Kabi	W
141	Roxithromycin	Tab 300 mg	25.00	per 50	Arrow-Roxithromycin	W or P
142	Salbutamol	Oral liq 400 mcg per ml	50.00	per 150 ml	Ventolin	W
143	Salbutamol	Infusion 1 mg per ml, 5 ml	130.00	per 10	Ventolin	W
144	Salbutamol	Aerosol inhaler, 100 mcg per dose CFC free	4.18	per 200 dose OP	SalAir	W
145	Salbutamol	Nebuliser soln, 2 mg per ml, 2.5 ml ampoule	9.43	per 20	Asthalin	W
146	Silver nitrate	Sticks with applicator	60.64	per 100	Silver nitrate (KMS)	W
147	Sodium acid phosphate	Enema 16% with sodium phosphate 8%	3.70	per 1	Fleet phosphate enema	W
148	Sodium bicarbonate	Inj 8.4%, 10 ml vial	126.12	per 10	Sodium bicarbonate AFT	W
149	Sodium bicarbonate	Inj 8.4%, 50 ml vial	24.70	per 1	Biomed	W
150	Sodium bicarbonate	Inj 8.4%, 100 ml vial	25.31	per 1	Biomed	W
151	Sodium chloride	Inj 0.9%, 5 ml, prefilled syringe, non-sterile pack	12.60	per 30	Polyflush	W
152	Sodium chloride	Inj 0.9%, 10 ml, prefilled syringe, non-sterile pack	12.60	per 30	Polyflush	W
153	Sodium chloride	Inj 0.9%, 10 ml ampoule	7.50	per 50	Fresenius Kabi	W
154	Sodium chloride	Inj 0.9%, 20 ml ampoule	5.20	per 20	Fresenius Kabi	W
155	Sodium chloride	Inj 0.9%, 50 ml bag	124.20	per 60	Baxter	W
156	Sodium chloride	Inj 0.9%, 50 ml bag	147.75	per 75	Baxter-Viaflo	W
157	Sodium chloride	Inj 0.9%, 100 ml bag	88.80	per 48	Baxter	W
158	Sodium chloride	Inj 0.9%, 100 ml bag	105.60	per 60	Baxter-Viaflo	W
159	Sodium chloride	Inj 0.9%, 250 ml bag	50.40	per 24	Baxter	W
160	Sodium chloride	Inj 0.9%, 500 ml bag	1.53	per 1	Baxter	W
161	Sodium chloride	Inj 0.9%, 500 ml bag	27.64	per 18	Baxter	W
162	Sodium chloride	Inj 0.9%, 1,000 ml bag	1.58	per 1	Baxter	W
163	Sodium chloride	Inj 0.9%, 1,000 ml bag	18.96	per 12	Baxter	W
164	Sodium chloride	Irrigation soln 0.9%, 30 ml sachet	14.77	per 50	Aspen	W
165	Sodium chloride	Irrigation soln 0.9%, 30 ml ampoule	13.25	per 20	InterPharma	W
166	Sodium chloride	Irrigation soln 0.9%, 100 ml bottle	12.39	per 1	Baxter	W
167	Sodium citrate with sodium lauryl sulphoacetate	Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml	36.89	per 50	Micolette	W or P
168	Sodium valproate	Inj 100 mg per ml, 4 ml	41.50	per 1	Epilim IV	W
169	Suxamethonium chloride	Inj 50 mg per ml, 2 ml ampoule	35.40	per 10	Martindale	W
170	Tenecteplase	Inj 50 mg vial	2,390.00	per 1	Metalyse	W or S
171	Ticagrelor	Tab 90 mg	20.35	per 56	Ticagrelor Sandoz	W or P
172	Tramadol hydrochloride	Cap 50 mg	3.33	per 100	Arrow-Tramadol	W or P
173	Tranexamic acid	Inj 100 mg per ml, 5 ml ampoule	5.39	per 5	Tranexamic-AFT	W
174	Tranexamic acid	Inj 100 mg per ml, 10 ml ampoule	7.99	per 5	Tranexamic-AFT	W
175	Trimethoprim with sulphamethoxazole [Co-trimoxazole]	Tab trimethoprim 80 mg and sulphamethoxazole 400 mg	115.74	per 500	Trisul	W or P
176	Trimethoprim with sulphamethoxazole [Co-trimoxazole]	Oral liq 8 mg sulphamethoxazole 40 mg per ml	4.95	per 100 ml	Deprim	W
177	Valaciclovir	Tab 500 mg	9.64	per 30	Vaclovir	W or P
178	Valaciclovir	Tab 1,000 mg	17.78	per 30	Vaclovir	W
179	Water	Irrigation soln, 100 ml bottle	12.47	per 1	Baxter	W

Abbreviations

W = Wholesaler

P = Community Pharmacy

Changes to Section B of the Pharmaceutical Schedule

Some ambulance medicines listed in Section E need to be repacked into smaller quantities for use by ambulance service providers.

Community pharmacists need to be able to claim for these repacked medicines and distribution/ service costs as a BSO under the current terms of ICPSA.

All ambulance medicines listed in Section E of the Pharmaceutical Schedule that require repacking for ambulance service use, would also be listed in Section B.

To enable community pharmacy claiming, we need to:

List some of the ambulance medicines (set out in Section E) in Section B of the Pharmaceutical Schedule.
Amend current restrictions on medicines in Section B to enable use by emergency ambulance services.

New listings in Section B for ambulance repacking

Chemical	Formulation	Brand	Pack size	Price and subsidy
Glucose [Dextrose]	Oral soln 15 g per 80 ml sachet	HypoPak Glucose	per 50	$70.00

Amending restrictions in Section B for ambulance use

Additions in bold, deletions in strikethrough. Only relevant parts with proposed changes are shown.

Ticagrelor tab 90 mg

Subsidy by endorsement; can be waived by Special Authority SA2520 [PDF](external link) – Retail Pharmacy.

Subsidy by Endorsement - May be supplied on BSO to ambulance service providers under the provisions in Section E of the Pharmaceutical Schedule and the BSO is endorsed accordingly.

Tenecteplase

We have reached a provisional agreement with Boehringer Ingelheim to list tenecteplase in Section B, Section E and Part II of Section H of the Pharmaceutical Schedule.

The provisional agreement is subject to consultation and approval by the Pharmac Board or its delegate.

Chemical	Formulation	Brand	Pack size	Price and subsidy
Tenecteplase	Inj 50 mg vial: powder for, vial (&) inert substance diluent, syringe	Metalyse	1	$2,390.00

Tenecteplase would be subject to an endorsement in Section B limiting funded use to relevant clinical indications, as follows:

Funding restrictions

Tenecteplase inj 50mg vial

Up to 1 inj available on a PSO
Only on a PSO
Subsidy by Endorsement – Only for use within a Primary Response in Medical Emergencies (PRIME) service and the PSO is endorsed accordingly

About the Pharmac model

Requests for funding new ambulance medicines

The Pae Ora Act says Pharmac must decide which medicines to fund for the best health outcomes for New Zealanders, while staying within our budget. When deciding which new medicines to fund, we compare each application against all the applications we have received. We decide which medicines are our priorities to fund.

This means any new ambulance medicine funding proposal would to need to be considered alongside all other medicine funding applications and depending on Pharmac’s available budget and relative priority of the funding application, the new ambulance medicine may or may not be funded.

This is consistent with the existing situation for funding of emergency medicines used within Health NZ hospitals.

Find out more about how Pharmac decides which medicines to fund

Many medicines are already funded

It is likely that many medicines that may be added to the paramedic scope of practice would already be funded by Pharmac for use in other settings. Requests to add these to Section E would be considered a change in service model for these medicines, rather than a new funding application.

We may also need to fund a new medicine as an alternate in the event of a supply shortage.

Suitability considerations

It is becoming increasingly clear how important suitability is for ambulance medicines, and the need for us to lean into this quadrant in our Factors for Consideration Framework.

In working through the proposed ambulance medicines Section E list, we have identified differences in the formulations of medicines that are used in hospitals and in emergency ambulance services, which all relate to suitability within this unique working environment. Sometimes ambulance service providers need to use a different formulation/presentation to get the same result as providers working in a hospital setting.

We also need to understand how ambulance service providers carry medicines in emergency road and air ambulances. For example, some intravenous medicine ampoules required for emergency level care are carried in specially made sleeves to fit the size and shape of currently purchased ampoules. Should Pharmac consider funding a different brand, we would need to understand the particular practical implications of such a brand change on ambulance service providers.

Pharmac plans to work with ambulance service providers to establish regular communication and clear guidance to support these individual funding requests and better understand the ambulance unique working environment.

To provide feedback

You can provide feedback by emailing consult@pharmac.govt.nz or using the online form by 5pm on 2 April 2026.

A summary of all feedback received before the closing date will be considered by Pharmac’s Board (or its delegate) prior to making a decision on this proposal.

Your feedback may be shared

When you give feedback on a consultation, your feedback becomes official information that Pharmac holds. Pharmac has legal responsibilities for how we manage this official information, under laws such as the Official Information Act and Privacy Act.

Pharmac may receive a request from people for official information, which could include your feedback. Legally, Pharmac must consider whether your feedback should be released.

We will consider your views when assessing whether the feedback has to be released. Tell us if there is anything about your feedback that you would prefer wasn’t released.

If your feedback is proposed for release, then Pharmac will contact you, unless there is a legal reason that we can't.

Note that Pharmac collects and holds your information in line with our Privacy Statement.