Teplizumab in New Zealand – a Speculative Article
With the recent approval of teplizumab in countries including Australia, the United Kingdom, and the United States, I can’t help but explore what might be on the horizon for our whanau living with Type 1 Diabetes here in Aotearoa New Zealand.
Teplizumab represents a new type of therapy for Type 1 Diabetes. Rather than treating the condition after diagnosis, it aims to delay progression before symptoms even begin. For families affected by Type 1 Diabetes, that shift feels significant.
But access to new medicines in New Zealand follows a structured and often lengthy pathway. Understanding that pathway can help explain what might happen next — and why.
What Has Been Approved Overseas?
Teplizumab (brand name Tzield) has been approved in several countries for people with early-stage Type 1 Diabetes.
In Australia, approval has been granted for individuals aged 8 years and older who are in what is known as Stage 2 Type 1 Diabetes. This means they have evidence of autoimmune activity (autoantibodies) and early changes in glucose regulation but have not yet developed clinical diabetes.
The goal of treatment is to delay progression to Stage 3 — the point at which insulin is required.
>> More on the Stages of Type 1 Diabetes
Clinical trials suggest that, on average, teplizumab can delay the onset of clinical Type 1 Diabetes by around two to three years, with some individuals experiencing longer delays.
This is why the therapy has attracted significant international attention. It represents the first widely approved treatment designed to modify the underlying autoimmune process rather than simply replacing insulin after diagnosis.
Is Teplizumab Available in New Zealand?
At the time of writing, teplizumab is not approved for use in New Zealand.
This means it has not yet been assessed and authorised by Medsafe, New Zealand’s medicines and medical devices safety authority.
And it is not funded by Pharmac, the agency responsible for deciding which medicines are publicly funded in Aotearoa.
There is often a time lag between a medicine being approved overseas and becoming available in New Zealand. In some cases, medicines may never be approved or funded locally, depending on a range of clinical, economic, and system-level factors.
What Would Need to Happen Next?
For teplizumab to become widely available in New Zealand, several steps would typically need to occur.
1. Medsafe approval
The manufacturer would need to apply for approval from Medsafe. This involves a detailed review of the medicine’s safety, quality, and effectiveness.
2. Pharmac assessment
If approved, Pharmac would then evaluate whether the medicine should be publicly funded. This includes assessing clinical benefits, cost-effectiveness, and how it compares to other funded treatments.
3. Budget prioritisation
Pharmac operates within a fixed budget. Even if a medicine is considered clinically beneficial, it must compete with many other medicines for funding.
4. Implementation
If funded, health services would need to determine how the treatment is delivered — including who is eligible, where it is administered, and how patients are identified.
Each of these steps takes time, and none are guaranteed.
Why Might Getting Teplizumab Funded be a Challenge?
For starters, teplizumab is a biologic therapy, produced using complex biotechnology processes. Biologic medicines are typically expensive, particularly when first introduced.
Pharmac must consider not only the cost of the medicine itself but also:
- The number of people eligible for treatment
- The infrastructure required to deliver it (including infusion services)
- The long-term benefits relative to cost
- Competing priorities across the entire health system
There is also an added layer of complexity with teplizumab. Unlike many medicines that treat people already diagnosed, teplizumab is used before clinical disease develops. This means identifying eligible individuals requires screening programmes, including autoantibody testing and follow-up monitoring.
These systems are not yet widely established in New Zealand.
What Might Support Future Access?
Despite these challenges, there are several factors that could support eventual access in New Zealand.
- Growing international approval and clinical experience
- Increasing focus on early intervention in type 1 diabetes
- Evidence suggesting delayed onset may reduce complications and healthcare burden over time
- Advocacy from clinicians, researchers, Diabetes New Zealand, and the diabetes community
As more data emerges — particularly around long-term outcomes — the case for funding may become clearer.
What Might Slow Progress?
At the same time, there are factors that could slow or limit access.
- High upfront cost of treatment
- Uncertainty about long-term benefits beyond delaying diagnosis
- The need for national or targeted screening programmes
- A relatively small eligible population
- Pressure on the medicines budget from many competing therapies
These are not barriers unique to teplizumab. They are part of how medicine funding decisions are made in New Zealand.
Could People Access It Privately?
If teplizumab were approved by Medsafe but not publicly funded, private access might eventually be possible.
However, this would likely involve several practical challenges.
Teplizumab is not a simple prescription medication.
Access would likely require:
- Specialist assessment
- Confirmation of Stage 2 Type 1 Diabetes
- Autoantibody testing
- Monitoring before and after treatment
- Administration via intravenous infusion over multiple days
In addition, the cost of treatment could be substantial if not publicly funded.
So, for most people, private access would not be straightforward.
Reminder: Who Would Actually Be Eligible?
One of the most important — and often misunderstood — aspects of teplizumab is who it is designed for.
It is not intended for:
- People already living with established Type 1 Diabetes
- People without evidence of autoimmune activity
- People with Type 2 Diabetes
Instead, it is designed for a very specific group:
People who have:
- Two or more diabetes-related autoantibodies
- Evidence of early glucose dysregulation
- Not yet developed clinical (Stage 3) diabetes
This means that even if the treatment becomes available, only a relatively small number of people would currently qualify.
Identifying those individuals would depend heavily on screening programmes and early detection.
A Shift in Perspective: Hope Versus Hype
Teplizumab has been described as a breakthrough — and in many ways, it is.
For the first time, a therapy has been shown to delay the progression of type 1 diabetes by targeting the immune system before symptoms begin.
But it is equally important to keep expectations grounded:
- Teplizumab does not cure Type 1 Diabetes.
- It does not prevent it indefinitely.
- It does not remove the need for insulin once clinical diabetes develops.
What it offers is something different: time…
- Time without the daily demands of insulin therapy.
- Time before the challenges of managing blood glucose become a lived reality.
- Time that may, in the future, be extended further through combination therapies or new advances.
So for New Zealanders, the question remains: how — and when — New Zealand’s regulatory systems, funding decisions, and healthcare infrastructure will adapt to support this new approach.
And that conversation is yet to be started.
Published 01 June 2026
Related Article: Type 1 Diabetes, Autoimmunity, and Teplizumab
| LEGAL DISCLAIMER: The information on this website is provided for general educational purposes only and is intended for a New Zealand audience. It is not a substitute for professional medical advice, diagnosis, or treatment. While I strive to ensure accuracy and relevance, please always seek guidance from your healthcare provider for personal medical decisions. Use of the content is at your own risk. Links to other sites are for convenience and do not imply endorsement. |
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