Pharmac seeks feedback on widening access to febuxostat for people with gout

Pharmac is seeking feedback on widening access to febuxostat to treat gout, by removing the requirement to trial probenecid.

If approved, febuxostat would be funded from 1 February 2027 for people with gout whose symptoms cannot be adequately controlled with allopurinol or who cannot tolerate allopurinol. 

Currently, people must trial two other medicines, allopurinol and probenecid, before becoming eligible for funded febuxostat.

These changes would give patients and clinicians two options for second-line treatment: febuxostat or probenecid. For some people, febuxostat may be the preferred option because it only needs to be taken once a day and it can be easier to adjust the dose if needed.

If the proposal is approved, febuxostat would be funded from 1 February 2027 for people with gout whose symptoms are not well controlled with allopurinol, or who cannot take allopurinol because of adverse effects.

Gout is a form of arthritis caused by a build-up of uric acid in the body. When uric acid levels become too high, urate crystals can form in and around the joints, leading to painful gout attacks that can cause sudden swelling, redness, tenderness, and severe pain.

Around 90% of uric acid levels are influenced by genetic factors and how effectively the kidneys remove uric acid from the body. 

If uric acid levels remain elevated, urate crystals can continue to build up over time. Without effective treatment, these crystals may cause permanent joint damage and can also affect kidney health.

Febuxostat is a urate-lowering medicine that works by reducing the production of uric acid, helping to dissolve existing urate crystals and prevent new crystals from forming.

Taking febuxostat can help prevent gout attacks and reduce the risk of long-term joint and kidney damage caused by ongoing crystal build-up.

We estimate that around 5,500 people would benefit from treatment within the first year of funding. This would increase each year up to 7,300 people in year 5.

You can give feedback using the online form linked in the online consultation document(external link).

Feedback will be accepted until 5pm, Wednesday 30 September 2026 with all feedback received before the deadline will be considered before a decision is made.

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.