Widened access to diabetes medicines to benefit over 30,000 New Zealanders

Under new eligibility criteria introduced on 1 September, over the next 12 months around 14,000 more people with type 2 diabetes will be able to access funded medicines empagliflozin, empagliflozin with metformin, liraglutide and dulaglutide, with the number increasing to around 31,000 people after five years.

Pharmac Chief Medical Officer, Dr David Hughes, says prior to 1 September, around 145,000 people could access these medicines, which help lower blood sugar and reduce the risk of heart and kidney complications for some people.

“Type 2 diabetes affects hundreds of thousands of New Zealanders and can lead to serious complications including heart and kidney disease.

“This decision means more people with type 2 diabetes will be able to access medicines that help lower blood sugar levels and reduce the risk of future complications which hugely impact their quality of life and, ultimately, put extra burden on the health system,” says Dr Hughes.

The medicines will be funded for New Zealanders with type 2 diabetes whose blood sugar levels remain high despite treatment with other funded diabetes medicines.

The change widens access to these medicines by removing the requirement that people have a history of cardiovascular or renal disease, elevated risk of cardiovascular disease, and existing ethnicity criteria.

Existing criteria requiring elevated blood sugar levels remain.

“For people living with type 2 diabetes, earlier access to effective treatment can help improve blood sugar control and support better long-term health outcomes,” Dr Hughes says.

The decision to widen access followed major consultation during May this year with people living with type 2 diabetes, their families and whānau, health professionals, community organisations and advocacy groups.

Pharmac originally proposed widening access to these medicines by lowering the clinical cardiovascular risk threshold for heart disease (how likely someone is to have a heart attack in the next five years) and removing ethnicity-based eligibility criteria.

“While people supported widening access to these medicines, many were concerned that removing the ethnicity criteria would mean Māori and Pacific peoples, who are eligible for these medicines under the current criteria but not currently accessing treatment, would miss out,” says Dr Hughes.

“We carefully considered that feedback and have changed our original proposal in line with that feedback. Working with suppliers, we were able to support wider access than originally proposed.

“The final decision removes the cardiovascular risk threshold and ethnicity criteria and introduces broader access criteria based on poor blood sugar control.”

Access to these medicines will now be based on a single set of funding criteria, making more people with type 2 diabetes eligible for funded treatment.

Everyone, including Māori and Pacific people, who would currently be able to access these medicines would meet these revised criteria.