Initial application from any relevant practitioner (including GPs, nurse practitioners and pharmacist prescribers). Approvals valid without further renewal unless notified for applications meeting the following criteria1:
All of the following:
1. Patient has type 2 diabetes; and
2. Any of the following:
- 2.1 Patient is Māori or any Pacific ethnicity; or
- 2.2 Patient has pre-existing cardiovascular disease or risk equivalent*; or
2.3 Patient has an absolute 5-year cardiovascular disease risk of 15% or greater according to a validated cardiovascular risk assessment calculator; or
2.4 Patient has a high lifetime cardiovascular disease risk due to being diagnosed with type 2 diabetes during childhood or as a young adult; or
2.5 Patient has diabetic kidney disease **; and
3. Target HbA1c (of 53 mmol/mol or less) has not been achieved despite the regular use of at least one blood-glucose lowering agent (eg, metformin, vildagliptin, or insulin) for at least 3 months; and
4. SGLT2 therapy will not be funded if patient is taking a funded GLP1, and vice versa.
Criteria 2.1 – 2.5 describe patients at high risk of cardiovascular or renal complications of diabetes.
* Defined as: prior cardiovascular disease event (ie, angina, myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, transient ischaemic attack, ischaemic stroke, peripheral vascular disease), congestive heart failure or familial hypercholesterolaemia.
** Defined as: persistent albuminuria (albumin:creatinine ratio greater than or equal to 3 mg/mmol, in at least two out of three samples over a 3-6 month period) and/or eGFR less than 60 mL/min/1.73m2 in the presence of diabetes, without alternative cause.
Click here to read the updated New Zealand Society for the Study of Diabetes (NZSSD) guidance on the management of type 2 diabetes, which includes the new medicines.
1. PHARMAC press release 21 December 2020.