Medication and Supplies

NOTE: This page describes systems and processes that are specific for eligible people living in New Zealand.

What’s covered on this page

Introducing Medicines
Medical Devices and Other Supplies
Prescription Items

MedsafePHARMACSo Who Pays What?

Consumer Guide (external link)

Introducing Medicines

Medicines are a sub-set of therapeutic products, further broadly categorised into:

  • Prescription medicines, which require a prescription and can only be dispensed by a pharmacist;
  • Restricted medicines (pharmacist-only medicines), which can be obtained without a prescription, but must be dispensed by a pharmacist;
  • Pharmacy-only medicines, which can only be obtained from a pharmacy;
  • Over-the-counter medicines;
  • Complementary or alternative medicines.

Original (‘innovative’ or ‘brand name’) medicines are new medicines; generic medicines are later copies of the original product, and these tend to be cheaper. As of 1996, in New Zealand a pharmacist may replace a brand name item with a generic item for cost saving purposes (“generic substitution“).

Tablets and insulins for blood glucose control are classified as prescription medicines.

WHAT’S IN A NAME? Brand name is the original name for a medicine Manufacturer’s name is a name given to the product as made by a given manufacturer Chemical name usually relates to the active ingredient Form relates to whether the medicine is in the form of capsules, tablets, cream, injection solution… and so on Strength describes the concentration of the active ingredient Extemporaneously compounded substances are made up by pharmacists from a concentrated source (e.g. powder)

Medical Devices and Other Supplies

Other items that might be required on a regular basis by someone with diabetes may include the following:

Insulin Pens Needles Syringes Insulin Pumps/
Pump consumables
Meters Strips Lancets
see “Using Insulin see “Blood Glucose Testing

Prescription items

Most of your diabetes medications and supplies will be obtained as prescription items. Some items might be available over the counter, but it may be cheaper to get them with a prescription if they are subsidised items.

Medsafe classifies medicines and medical devices – this determines whether a prescription is required for the consumer to obtain the medicine and, (if a script is not required,) where the product may be sold. MedSafe approves a medicine for use in New Zealand; PHARMAC negotiates the price the Health system will pay for that medicine, and sets out conditions for the payment of subsidies.

MEDSAFE Medsafe is the New Zealand Medicines and Medical Devices Safety Authority. It is a business unit of the Ministry of Health (MOH) and is responsible for the regulation of the use of therapeutic products, including: Medicines (including clinical trials) Herbal remedies Controlled drugs (used as medicines) Vaccines Blood / blood products Medical devices* *Unsafe products can be withdrawn from the market Additionally, Medsafe has regulatory roles in numerous other positions along the medicine supply chain. Medsafe also plays a regulatory role in the advertising of therapeutic products in New Zealand. By law, Medsafe must approve all medicines and related products or items before they can be marketed in New Zealand. A number of different independent advisory committees inform Medsafe on a variety of issues, enabling access to a solid base of medical and pharmaceutical expertise
PHARMAC PHARMAC is the Pharmaceutical Management Agency – a Crown entity that supports section 46(1) of the New Zealand Public Health and Disability Act (2000) PHARMAC is accountable to the Minister of Health. It’s primary objective is to ensure the best health outcomes for people who need pharmaceuticals that can be reasonably achieved from pharmaceutical treatment, given the available funds (i.e. the Pharmaecutical Budget). PHARMAC facilitates a list of subsidised pharmaceuticals – known as the Pharmaceutical Schedule. Pharmaceutical manufacturers and suppliers apply to PHARMAC to have a given medicine included in the list. The PHARMAC Board (appointed by the Minister of Health) makes the ultimate decisions regarding level of subsidy and dictates prescribing guidelines and conditions, with some input from independent medical experts from the Pharmacology and Therapeutics Advisory Committee and specialist sub-committees. Consumer input into PHARMAC’s decision-making processes is made possible through the Consumer Advisory Committee. PHARMAC also acts to promote the responsible use of pharmaceuticals, and to oversee purchasing of hospital pharmaceuticals on behalf of District Health Boards (DHBs).

So Who pays What?

Subsidised items

A large part of the cost of a subsidised item is met by the Government and comes out of the Pharmaceutical Budget. A small part of the cost is usually met by the patient – the prescription charge – which is currently $5 per item for a 3-month supply of a fully subsidised item (see box below). Occasionally a manufacturers surcharge* or an afters-hours fee may be applicable. As of July 2015, no co-payment for subsidised prescription items is required for children under 13 years. i.e. presriptions for fully subsidised items are free for children under 13 years.

Help with payments

New Zealanders can reduce their prescription costs by using the Prescription Subsidy Card (PSC), also known as the prescription subsidy card or prescription exemption card. Once an individual or family has reached a total of 20 items they will qualify for the PSC. Therefore no individual or family with a subsidy card will pay more than a total of $100 per year in pharmaceutical co-payments

The definition of family for eligibility for the subsidy card is:

  • a married (or de facto) couple, with one or more dependent children or
  • a married (or de facto) couple, with no dependent children or
  • one person with or without children.

Visit the Ministry of Health FAQ page  for more on the $5 co-payment.

The Community Services Card and HIgh Use Health Card an provide additional help in paying for prescriptions in some circumstances.

*Not all items that are subsidised are fully subsidised. According to PHARMAC, the agency aims to fully subsidise at least one item in each therapeutic group. However, although PHARMAC does have contracts with some suppliers to maintain the price of given products, manufacturers are able to set their own price to pharmacies. If the price exceeds the subsidy, the pharmacist may recoup the difference from the patient.

Special Authority items

A prescriber (e.g. your doctor) can go through a special process to request that a given item be subsidised for a particular person on an individual basis. This is known as a Special Authority application. If certain criteria (set by PHARMAC) are met, the application should be approved, and a Special Authority number is assigned, which must appear on the script in order for the subsidy to be paid.