Pharmac to fund the EpiPen for severe allergies 

Te Pātaka Whaioranga - Pharmac has confirmed today that it will be fully funding the EpiPen brand of adrenaline auto injectors from 1 February 2023, which will benefit thousands of New Zealanders.

“We are pleased to be able to share that adrenaline auto-injectors will be funded for anyone who has previously experienced a severe allergic reaction, known as anaphylaxis, or anyone who is at significant risk,” says Pharmac’s director of operations Lisa Williams.

“Funding adrenaline auto-injectors will improve the quality of life for thousands of individuals who have allergies, their caregivers and whānau. We estimate that there will be around 12,000 people accessing adrenaline auto-injectors in the first year of funding, increasing to 17,000 people per year after five years,” says Ms Williams.

“Pharmac would like to acknowledge everyone who summited feedback on the consultation,” says Ms Williams. “The responses were supportive of funding and offered suggestions to make sure that everyone eligible can access them. This feedback has made sure adrenaline auto-injectors will make a considerable difference to people’s lives.”

One change we have made, after considering feedback about the diversity of patient pathways and the risk of inequities, is to allow access criteria applications for funding (which includes assessment of anaphylaxis risk) by any relevant practitioner rather than by a specialist. We consider this better reflects the multi-disciplinary nature of our healthcare system and will support more equitable access to adrenaline auto-injectors for those who need them.

Allergy New Zealand’s chief executive Mark Dixon says, “We are delighted with Pharmac’s decision and recognise everyone who has worked so hard to raise awareness of the need for this funding. We know the hugely positive impact it will make on the lives of the thousands of New Zealanders living with the risk of anaphylaxis. On their behalf we are grateful and look forward to working with Pharmac to ensure all communities have equal access and knowledge to benefit from this decision.”

“We were really pleased to share this decision with Allergy New Zealand and look forward to working with them to help New Zealanders benefit from this treatment,” says Ms Williams. “We are working to be faster, clearer, and simpler with our funding decisions. Today’s decision is one of many that we’ve made this year and we’re pleased to say there are more to come.”

Learn more
• People can learn more about the EpiPen brand of adrenaline auto-injectors through the supplier’s website, https://www.epipen.com/en and at www.allergy.org.nz/education/anaphylaxis/

Pharmac funding process

We understand that our processes are very specific to our work, so we’ve added a reminder below about the stages of our work that we commonly share with the media. We do this to help spread awareness of our activities and decisions to the wider public. Before public release of information, Pharmac shares information to stakeholders who will be impacted by announcements.

Prioritisation:

• Once Pharmac has received clinical advice and decided a medicine or related product is something we would like to fund we ranked it on our options for investment list (OFI). We publish our prioritisation lists on our website (in alphabetical order) and we have started making regular announcements about significant changes to the OFI. We use an evidence-based approach to prioritise the options using our factors for consideration, which require us to look at health need, health benefits, suitability and costs & savings.

Consultation:
• Consultation occurs after we have reached a provisional agreement with the supplier which is conditional on public feedback and a Board (or its delegate) decision. At this time the funding for the medicine, medical device vaccine or related product has not been approved. We publish consultations on our website and send them directly to interested stakeholders who have subscribed to receive them. We also announce them to the media as a way of ensuring that those who are not directly connected with us, but might be affected by the proposal, can be made aware.
• During consultation we ask New Zealanders what they think about our proposal to fund the product, the eligibility criteria, the timing and any support required to implement the decision. We work with the supplier and health sector to consider whether changes are appropriate following consideration of the feedback received.

Notification:
• Once a final decision has been made on the proposal to fund the product we will notify the public about this. If the funding is approved, there is always a period between notifying the public of the decision and commencement of funding, as the health sector generally needs time to prepare for implementation, for instance service planning and set up and ensuring sufficient stock is available in New Zealand to meet demand.