Source: PHARMAC
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.
“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 consider creating a claiming mechanism similar to that used by public hospitals.
