Pharmac proposes to widen access to two medicines for people with melanoma

24 February 2026

Media release Medicines

At a glance

Pharmac is proposing to widen access to two medicines for people with melanoma, before surgery, from 1 May 2026.
The proposal would fund nivolumab and ipilimumab together for people with stage 3B to stage 4 melanoma that can be removed with surgery.
This would provide an additional funded treatment option that helps to reduce the risk of the cancer returning and could mean less treatment for some people.

Pharmac is proposing to widen access to two medicines used to treat melanoma, giving people another funded immunotherapy option that can help lower the chance of the cancer coming back.

The proposal would allow people with stage 3B to stage 4 melanoma, that can be removed with surgery, to receive nivolumab in combination with ipilimumab before surgery. People who require further treatment after surgery would also have access to funded nivolumab or other funded treatments if suitable.

“Treating melanoma with immunotherapy before surgery can significantly improve how well treatment works,” says Pharmac’s Director of Pharmaceuticals, Adrienne Martin. “This proposal would give people access to another effective treatment option that helps reduce the risk of melanoma returning after surgery.”

Pharmac’s clinical advisors have said that using these treatments together, before surgery, and then adjusting treatment after surgery based on how well the cancer has responded, can lower the chance of melanoma coming back. This approach has been shown to work better than using nivolumab on its own after surgery. Nearly two in three people have a very strong response by the time their tumour is removed, with significant shrinkage or very little active disease remaining.

“For many people, a strong early response may mean less treatment after surgery, with fewer infusions, and less disruption to daily life,” says Martin. “This also eases pressure on infusion clinics and helps the health system manage growing demand.”

People who still need treatment after surgery would continue to have access to funded nivolumab through this proposal, or other funded treatments if suitable.

Pharmac currently funds pembrolizumab, for people with melanoma which can be removed by surgery. Funding nivolumab combined with ipilimumab would mean that some patients would require fewer infusions, which would reduce pressure on hospital oncology infusion centres, and free up resources.

Pharmac estimates around 155 people would receive this treatment in the first year, increasing to about 166 people per year after five years. Most of the people in this group would have otherwise received funded pembrolizumab. Nivolumab and ipilimumab are already approved for use in New Zealand and are funded for some other cancers.

Pharmac is seeking feedback on the proposal from people with melanoma, their whānau and carers, health professionals, and other interested groups.

Consultation closes at 5 pm, Friday 6 March 2026. Feedback can be emailed to consult@pharmac.govt.nz. All feedback received before the closing date will be considered before a decision is made.

Proposal to widen access to nivolumab and ipilimumab for resectable melanoma

Questions and answers

What is Pharmac doing?

Pharmac is consulting on a proposal to widen funded access to nivolumab and ipilimumab for people with stage 3B to stage 4 melanoma that can be removed with surgery, from 1 May 2026.

If approved, this would allow eligible people to receive nivolumab with ipilimumab before surgery (neoadjuvant treatment). People who still need treatment after surgery would continue to have access to funded nivolumab.

Why is Pharmac doing it?

Pharmac is proposing this change because clinical advice shows that treating melanoma before surgery, improves outcomes.

Using nivolumab with ipilimumab before surgery has been shown to:

Lower the chance of melanoma coming back, and work better than using nivolumab alone after surgery, with around two in three people having a very strong response by the time their tumour is removed.
Reduce the amount of treatment many people need after surgery, meaning fewer ongoing infusions, fewer hospital visits, and less time spent receiving treatment for patients, families, and carers.
Ease pressure on hospital services, as fewer infusions are needed overall, saving an estimated 1,000 infusion hours each year and freeing up resources in oncology infusion centres.

What are nivolumab and ipilimumab?

Nivolumab and ipilimumab are immunotherapy medicines, also known as immune checkpoint inhibitors.

They work by blocking specific checkpoint pathways that normally limit the immune response, allowing the immune system to better recognise and attack cancer cells.

When used together, they have a greater effect on the immune response than when used alone.

Both medicines are given by intravenous infusion, are approved by Medsafe, and are already funded in New Zealand for some other cancers.

What is melanoma?

Melanoma is a type of skin cancer that develops in melanocytes, the cells that give skin its colour. It is caused by exposure to ultraviolet (UV) radiation from the sun.

New Zealand has the highest recorded incidence of melanoma in the world, with over 7,000 people diagnosed each year, including more than 3,000 cases of invasive melanoma.

Stage 3 melanoma means the cancer has spread to nearby lymph nodes or nearby skin.
Stage 4 melanoma means the cancer has spread to more distant parts of the body.

How can I give feedback?