New Zealanders with cancer will have greater continuity
of care from today, following Pharmac’s decision on
amending pharmaceutical schedule rules to allow access to
new publicly funded cancer medicines in private hospitals
and clinics.
From 1 July 2025, when Pharmac funds a
new cancer medicine or widens access to existing funded
cancer medicines, eligible patients will be able to receive
their medicine within private hospitals or clinics for a
period of up to 12 months, without having to move their care
to a public hospital.
“This decision will
provide greater continuity of care for New Zealanders with
cancer,” says Pharmac’s Director Strategy, Policy and
Performance, Michael Johnson.
In the past, patients
whose cancer medicines became publicly funded during their
treatment found themselves having to transfer their
treatment to a public hospital to access publicly funded
medicines or else continue their private treatment and
self-fund the costs.
“This change will allow these
patients to benefit from newly funded cancer medicines,
while maintaining their current treatment plans,” Johnson
says.
To be eligible, patients must
already be receiving treatment at the date that their cancer
medicine becomes funded by Pharmac, or have an approved
treatment plan, and are about to start treatment at the date
that their medicine becomes funded. This policy applies only
to newly funded cancer medicines after 1 July
2025.
To support the Government’s
decision to enable transitional access to publicly funded
medicines in private settings, Pharmac consulted on rule
changes to the pharmaceutical schedule between 26 May – 13
June 2025.
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“While most people were supportive, we
have listened to feedback and have decided to change the way
we plan to implement this decision,” Johnson
says.
Pharmac initially proposed that private
facilities would be able to obtain the funded medicine from
public hospitals, as private hospitals are not currently
able to make subsidy claims for cancer
medicines.
“However, people told us this approach
wouldn’t work and would likely lead to patient safety
risks due to double handling of medicines, process
differences between public and private, and incompatibility
of administration kits,” Johnson says.
“People
told us they would prefer for private facilities to directly
order cancer medicines and submit subsidy claims to Pharmac.
We’ve listened to this feedback and have decided to change
the way we plan to implement this decision,” Johnson
says.
Initially, Pharmac will work with private
facilities to implement a direct payment arrangement for the
cancer medicines that fall under this policy. Pharmac will
in the future look to work with private facilities, Health
NZ and suppliers
to
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