Not all medicines are funded in New Zealand and every year Kiwis need non-PHARMAC funded medicines that can cost thousands of dollars, leaving those New Zealanders out of pocket. nib’s non-PHARMAC Plus Option can help cover the cost of non-funded medicines and provide your clients with access to more treatment options when they really need it.
In the 2023 financial year nib covered 512 claims for non-PHARMAC medicines, providing vital treatment for 107 members.
The five highest value claims paid to individual members during that time were:
Out of 20 OECD countries (including Australia, Finland, and Great Britain) New Zealand ranks last for the number of publicly funded modern medicines, which can limit our access to the latest treatments for chronic diseases and cancers.
Among the 441 modern medications introduced in 20 OECD countries from 2011 to 2020, just 131 (30%) have obtained registration in New Zealand, making them available for prescription to Kiwi patients.
Petitions have been submitted to parliament amassing thousands of signatures, all seeking funding for a broad spectrum of life-transforming or life-saving drugs
Rob Hennin, nib CEO, says “The cost of non-Government funded medicine can run to the hundreds of thousands of dollars and patients may have limited options if they are unable to access treatment through health insurance or self-funding".
“Some patients have opted to move overseas or source donations to fund treatment and for others the only option is to forgo treatment altogether.”
Rob McGrath, nib Chief Medical Officer, says health insurance can provide access to non-funded, Medsafe approved drugs that can extend and/or significantly improve a patient's quality of life.
“There are a number of cancer drugs that are not funded in New Zealand but have the potential to significantly improve health outcomes and quality of life for patients. nib has paid claims for chemotherapy drugs such as Trametinib (Mekenist), Capecitabine (Brinov) and Carfilzomib (Kyprolis), and targeted cancer drug Daratumumab (Darzalex) and immunotherapy drug, BCG treatment for bladder cancer.
“Other non-PHARMAC medicines nib members have accessed include Enzalutamide (Xtandi), a hormone therapy for cancer, Visudyne, a photosensitising agent, and joint injectables Cingal (hyaluronic acid and cortisone combination) and Botox for TMJ” says McGrath.
Most people don’t think about the cost of non-funded medicines until they or a loved one need them. Talk to your clients about the benefits of non-PHARMAC cover today.