Source: PHARMAC
Pharmac is proposing changes to the Special Authority and Hospital Indication Restrictions criteria for four biologic medicines: infliximab, etanercept, secukinumab, and rituximab.
These medicines are used to treat a range of autoimmune and inflammatory conditions. The proposed changes aim to reduce administrative workload for clinicians, improve consistency across biologic treatments, and respond to feedback received during previous consultation.
Special Authority and Hospital Indication Restrictions are funding tools used by Pharmac to ensure medicines are targeted to those who would benefit most. They set out specific clinical criteria that must be met before a person can get a funded medicine.
“We’ve listened to feedback from clinicians, patient advocacy groups, and others,” says Pharmac’s Acting Manager of Pharmaceutical Funding, Claire Pouwels. “This proposal is about making the criteria easier to use and more consistent.”
The proposed changes include:
- Extending how long a Special Authority approval lasts
- Allowing any relevant health practitioner to apply for funding
- Removing renewal requirements for some conditions
- Aligning language and removing outdated clinical references
Pharmac previously consulted on changes to the access criteria for adalimumab in 2021. That consultation was well received, and many stakeholders asked for similar updates to other biologic medicines.
“These proposed changes will make a difference for people who rely on these medicines,” says Pouwels. “Fewer administrative steps means less waiting, fewer treatment disruptions, and more consistent access to care.
“We encourage anyone with an interest in these medicines to share their views.”
From 6 November 2025, Pharmac will begin public consultation on the proposed changes. Feedback will be open until 5pm on 27 November 2025.
