PHARMAC medicine funding: how applications enter the schedule

PHARMAC decides which pharmaceuticals are subsidised for DHBs (now Health NZ). Manufacturers and patient groups submit pharmacoeconomic evidence comparing cost-effectiveness against existing treatments.

The Factors for Consideration include health need, Māori health outcomes and budget impact. Unfunded medicines may still be prescribed privately at full cost — a political flashpoint in media each year.

Medsafe approval to use a medicine is separate from PHARMAC funding to subsidise it. Both tracks confuse patients searching 'why isn't my drug funded yet'.

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