News

PHARMAC released a communication this week (11th July 2019), which included changes to funded supplies for people with diabetes:

Quantity of funded insulin needles

Any changes to the original proposal?

No changes were made to this proposal as a result of consultation feedback.

This decision was subject to a consultation letter dated 30 May 2019.

Who we think will be most interested

  • People with diabetes who use insulin and their whānau
  • Community pharmacies
  • Diabetes specialists, diabetes nurse specialists, GPs, nurses
  • DHBs
  • Suppliers of insulin and insulin needles and syringes

Detail about this decision

The following changes will occur from 1 August 2019:

The maximum quantity of insulin syringes with attached needles and insulin pen needles will be amended in Section B of the Pharmaceutical Schedule from 1 August 2019 as follows (additions in bold and deletions in strikethrough):

INSULIN PEN NEEDLES – Maximum of 100 dev per prescription

a)      Maximum of 200 dev per prescription

b)      Maximum of 100 dev per dispensing

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE– Maximum of 100 dev per prescription

a)      Maximum of 200 dev per prescription

b)      Maximum of 100 dev per dispensing

Our response to what you told us

We’re grateful for the time people took to respond to this consultation. Responses were generally supportive of the proposal. A summary of the main themes raised in feedback and our responses to the feedback are set out below.

Theme PHARMAC Comment
Supportive of the change. Noted.
Queries regarding funding of lancets for blood glucose monitoring. Funding for lancets for blood glucose monitoring was not considered as part of this proposal. We note that dispensing costs to DHBs and co-payments to patients would be greater than the cost of purchasing these devices over the counter from a pharmacy.
Request for funding of new oral treatments and glucose monitoring systems for people with diabetes. Vildagliptin (a DPP-4 inhibitor), a new oral treatment for diabetes was funded from 1 October 2018. Other new oral treatments for diabetes, such as the SGLT-2 inhibitors and GLP-1 agonists are currently under assessment. Similarly, the Freestyle Libre monitor is also under assessment. Further information on applications currently under assessment can be found on PHARMAC’s application tracker.
Concern that many patients do not need to change needles more frequently, with a request for funding of other diabetes products, including the Freestyle Libre monitor.   The proposal is in line with the clinical advice that PHARMAC has received. Repeat prescriptions will allow patients who need more than 100 needles to access these without needing an additional prescription, whilst managing the risk of stockpiling in patients who do not need 200 needles at one time. Based on this, overall costs are estimated to be minimal with patients no longer having to pay to access additional prescriptions. Note an application for funding of the Freestyle Libre monitor is under assessment. Further information on this application can be found on PHARMAC’s application tracker.
Consider funding should be extended to include short insulin needles PHARMAC has received a commercial proposal to list shorter needle lengths for syringes with attached needles. This proposal is currently under assessment and will be considered at a future time.
General concern that the quantity funded may not be sufficient for some patients who require multiple injections a day and are prone to developing lipohypertrophy. The proposal is in line with the clinical advice PHARMAC has received. Patients requiring more than 200 needles over a three-month period would need an additional prescription to have this quantity funded but will now require fewer prescriptions compared to the current arrangement. PHARMAC will continue monitoring use and requirement for needles and may seek advice on increasing the quantities again in the future. 
General concern that increasing the quantity of funded insulin needles through a repeat prescription may present a barrier to treatment for some patients due to the requirement to go back to their community pharmacy. PHARMAC acknowledges that patients will still need to return to their community pharmacy for additional needles. This proposal will remove the requirement of an additional script and its associated co-payment for patients who need a quantity of needles greater than 100 per prescription, whilst managing the risk of stock piling in patients who do not need 200 needles at one time.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 66 00 50.