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Kia ora koutou,
The news out today from Pharmac about widening access to medications for people living with type 2 diabetes is a positive step forward for diabetes care in Aotearoa New Zealand.
As of September 1st, the Special Authority criteria for empagliflozin (Jardiance), dulaglutide (Trulicity) and liraglutide (Victoza) has been refined to open access to these medications previously unavailable to all people living with type 2 diabetes who have an HbA1c > 53 mmol/mol despite regular use of other glucose-lowering medications. This is in line with the evidence-based therapies recommended in the National Diabetes Roadmap, which NZSSD supports and removes the need for additional clinic visits and testing. (Click HERE for the Pharmac announcement)
We are mindful that there continues to be a mismatch between the revised Special Authority criteria and best clinical practice. People with type 2 diabetes and cardiovascular and/or renal disease will benefit from SGLT2i and/or GLP1Ra use irrespective of their HbA1c and it is important to continue to focus on our high-risk populations, particularly Māori and Pacific peoples. As is current practice, where appropriate, clinicians should consider the heart failure Special Authority for empagliflozin or discuss self-funding, including using the Disability Allowance.
The NZSSD Executive would like to thank you all for putting in your submissions and were very pleased that Pharmac were responsive to the significant number of submissions. We will continue to work with Pharmac to aim for open access to these medications for people with type 2 diabetes as per standard international care, including funded dual GLP1Ra/SGLT2i therapy where appropriate.
NZSSD will be updating their clinical guidance to ensure these changes in Special Authority are reflected.
Ngā mihi,
Dr Jo McClintock (she/her)
Consultant Clinical Psychologist |Kaimātai Hauora Hinengaro
President New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
Dr Ryan Paul(he/him/ia)
Ngāti Maru, Hauraki
Endocrinologist|Associate Professor of Medicine University of Waikato
Co-Chair Mahitahi Matehuka (National Diabetes Network)
ryan.paul@tewhatuora.govt.nz
Kia ora koutou,
You will be aware of the supply chain shortage of TruSteel Infusion Sets. This is having a real-life impact for many of our whānau on Tandem insulin pumps not being able to access their infusion sets. We have been in discussions with Pharmac about the challenges this presents to clinicians and whānau with diabetes.
At this time, NZSSD and Mahitahi Matehuka are strongly recommending that the following groups are prioritised for TruSteel infusion sets:
- Children
- Previous recurrent failures with Autosoft infusion sets
- No previous trial of Autosoft infusion sets but high risk of infusion set failure including:
o Allergy to teflon
o Significant lipohypertrophy/scar tissue at insertion sites
o Pregnancy
o Significant physical activity
Most people currently using TruSteel infusion sets will likely be suitable for switching to Autosoft infusion sets, but this has often not been previously discussed. A reminder that NZMS has put out resources (attached and below) for the AutoSoft infusion sets and we do recommend referring to these and passing them onto our whānau using Tandem insulin pumps as well.
- https://youtu.be/mly1nTqVEHc
- Autosoft 90 Quick Reference (attached)
Other recommendations for prescribers and clinicians are:
- Consider only doing three-month prescriptions for TruSteel infusion sets so as not to set up competition and potential misuse of prescriptions
- Ensure all people using TruSteel infusion sets have a backup plan with necessary supplies to return to multiple daily injections of insulin in case they cannot access infusion sets
- Starting new Tandem users on Autosoft infusion sets if suitable from the outset of pump therapy
We recognise that changing infusion sets can be upsetting for many people and does require additional clinical input. But there is no foreseeable end to the worldwide TruSteel shortage and it is important we maintain as many people on automated insulin delivery as possible. We will continue to provide regular updates as the TruSteel infusion set shortage remains a dynamic situation.
Ngaa mihi nui
Jo and Ryan
Dr Jo McClintock (she/her)
Consultant Clinical Psychologist |Kaimātai Hauora Hinengaro
President New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
Dr Ryan Paul(he/him/ia)
Ngāti Maru, Hauraki
Endocrinologist|Associate Professor of Medicine University of Waikato
Co-Chair Mahitahi Matehuka (National Diabetes Network)
ryan.paul@tewhatuora.govt.nz
Kia ora koutou,
Dr Jo McClintock (she/her)
Consultant Clinical Psychologist |Kaimātai Hauora Hinengaro
President New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
Associate Professor Rosemary Hall MBChB FRACP PhD
Endocrinologist
University of Otago - Ōtākou Whakaihu Waka
Department of Medicine
Wellington | Pōneke
rosemary.hall@otago.ac.nz
Pharmac is proposing to widen access to three funded medicines for some people with type 2 diabetes: empagliflozin, liraglutide and dulaglutide from 1 August 2026.
The medicines are already funded, and the proposal would widen access to people who are at higher risk of heart or kidney complications. The proposed changes include removing ethnicity-based eligibility criteria and lowering the five-year cardiovascular risk threshold to widen access.
If approved, around 10,000 more people are expected to benefit in the first year, increasing to around 23,000 people after five years.
When these medicines were first funded, Special Authority criteria were used to target treatment to population groups with a high health need. In 2025, Pharmac formalised its Access Criteria Policy, which means for every medicine considered for funding the target population is now defined by clinical condition and those most likely to benefit.
Pharmac has reviewed the criteria and received updated advice on how access could be widened while still reaching the people who need these medicines the most. Anyone who is already receiving these medicines will continue to have access and would not be affected by the proposed changes.
Pharmac is seeking feedback from people with type 2 diabetes, their whānau, health professionals, and advocacy groups.
The proposal will be published on Pharmac's website at 2pm, Thursday 14 May:
Ø Proposal to amend the special authority access criteria for type 2 diabetes medicines
Kia ora koutou,
Many of you are aware of the proposed changes of the HbA1c thresholds for diagnosing pre-diabetes and diabetes. Please see attached the health sector notice that describes the new thresholds and recommended management.
The information we have received is:
To best meet the needs of whānau and communities across New Zealand, Health NZ is taking a phased approach to HbA1c threshold changes implementation. Health care providers who are clinically and operationally ready are encouraged to adopt the new thresholds now, with full national implementation from 1 July 2026.
Updated clinical guidance, laboratory reporting systems and Health Pathways will align nationally from 1 July 2026.
Transition support and updates
Further communication and technical guidance will be distributed throughout the transition period. If you have questions or require support, please contact your contract manager or Mahitahi Matehuka National Diabetes Network at any time via email to DiabetesNetwork@TeWhatuOra.govt.nz.
If you have any questions for NZSSD about this then please do reach out.
Ngā mihi,
Jo
Dr Jo McClintock (she/her)
Consultant Clinical Psychologist | Kaimātai Hauora Hinengaro
President New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
Kia ora koutou,
A new guideline on periprocedural management of children and adolescents with diabetes mellitus is now available on the Starship website.
It is based on recently published research and has been co-developed by NZPES, ANZSPED, SPANZA, consumer representatives, and members of our Clinical Network for Children and Young People with Diabetes.
The guideline:
Please read the guideline and share it with relevant teams.
Kind regards,
Kati
Kati Wilson
Diabetes Network Project Coordinator
New Zealand Child and Youth Clinical Network
Pharmac has confirmed changes to Special Authority renewal requirements for selected medicines and products.
From 1 December 2025, Pharmac will remove the need to renew Special Authority approvals for the following treatments:
More information about Pharmac's decision is available at:
We're grateful to everyone who shared their views during consultation. Your feedback helped shape this decision.
We want to make sure that everyone who needs to know about this decision is aware of it. Please share this information with people you think might be interested.
Pharmac | Te Pātaka Whaioranga | P: 0800 660 050 | www.pharmac.govt.nz
FreeStyle Libre 2 Plus has launched to great success - supporting thousands of New Zealanders living with diabetes improve their glycaemic control. Pharmac has announced that from the 1st November 2025, FreeStyle Libre 2 will be discontinued and replaced by FreeStyle Libre 2 Plus.
MediRay are in the process of transitioning away from FreeStyle Libre 2 and need your help to upgrade your patients now to experience the benefits our new FreeStyle Libre 2 Plus sensor offers:
- Extended 15-day wear time
- Approved from age 2 years and up
- Our most accurate sensor#.1
- Funded by Pharmac for Patients with Type 1 Diabetes and some other specified forms of diabetes.
UPGRADE YOUR PATIENTS NOW: Transitioning your patients to FreeStyle Libre 2 Plus is NOT an automatic process.
Please complete a new prescription for your patients that are currently on a FreeStyle Libre 2, by writing on the new prescription 'FreeStyle Libre 2 Plus". The existing Special Authority does NOT need to be changed.
This will avoid the future rush when the current FreeStyle Libre 2 is withdrawn by Pharmac on the 1st November 2025.
If you require any further support, please feel free to contact Kevin Anderson on 021349991 or kevin@mediray.co.nz or visit FreeStyleConnect.co.nz.
Kevin Anderson
Division Manager - Diabetes Care
MEDIRAY
www.mediray.co.nz
Kia ora koutou
We have received the following communication from the Pharmac Implementation team:
YpsoPump is now iOS compatible
From 10 June 2025, the mobile phone application for the mylife YpsoPump is compatible with iOS phones.
Factsheet about CamAPS on iOS | Pharmaco website [PDF](external link)
Medtronic (MiniMed 770G) insulin pumps:
People currently using Medtronic MiniMed 770G insulin pumps have until 1 October 2026 to move to a different funded pump.
The 4-year rule does not apply to people moving from Medtronic insulin pumps
The "Maximum of 1 insulin pump per patient each four-year period" rule does not apply for people changing from a funded Medtronic pump to the Tandem or YpsoPump. They can receive a funded pump, even if they got their Medtronic pump less than 4 years ago.
More about insulin pumps, consumables and CGMs | Pharmac website
Please ensure that the brand of funded insulin pumps is chosen carefully.
It is vital that all considerations are made in relation to personal circumstances. Especially important is the difference in algorithms between the two brands which may not be compatible with an individual's needs. The requirement that the Ypso pump requires a smart phone to operate the closed-loop system is also an important factor to consider, as some people may have difficulty operating a phone.
Dulaglutide: New patients from 1 July 2025
From 1 July 2025, we lifted the "no new patient" restriction from dulaglutide (Trulicity). This follows our earlier decision to re-open access to liraglutide (Victoza) from 1 March 2025.
Eligible people with type 2 diabetes will be able to start using funded dulaglutide or liraglutide. The restriction had been placed on these medicines to help manage the global shortage, which had been caused by rapid increase in demand worldwide.
Questions:
If you have any queries, please contact: enquiry@pharmac.govt.nz
Please also visit the NZSSD website to view the NZSSD Type 2 Guidance for information on prescribing and monitoring recommendations.
Ngā mihi
Jo McClintock
President
NZSSD
Kia ora koutou
I am very pleased to share this news about access to GLP1a dulaglutide.
From 1 July 2025, Pharmac is removing the 'no new patient restriction' on the GLP1a dulaglutide (branded as Trulicity). This means people with type 2 diabetes, who meet the eligibility criteria, will be able to start on treatment with this medicine.
More information about the ongoing supply issue is available on the Pharmac website: Dulaglutide(Trulicity) and Liraglutide (Victoza): Supply issue
Please also visit the NZSSD Type 2 diabetes guidance for information on when/in which patients it is appropriate to prescribe a GLP1Ra, and prescribing and monitoring recommendations.
This is great news for people living with type 2 diabetes and the health professionals caring for them.
Ngā mihi nui
Jo
Dr Jo McClintock(she/her)
Consultant Clinical Psychologist |Kaimātai Hauora Hinengaro
President - New Zealand Society for the Study of Diabetes
Kia ora koutou
A bit of a mixed bag update but an essential one. Thanks to all who have reached out about the CVD calculator. We have updated the website to prioritise the more accurate and contemporary VAREANZ risk predictor calculator which includes an equation for people with type 2 diabetes. https://nzssd.org.nz/resources/section/calculators
We have been made aware of a number of deep fakes promoting fake "diabetes medications" that are using NZSSD members names, faces, and voices. This is a serious concern that requires wide spread awareness. Attached is our media release and we would appreciate if you can circulate this on your own or your workplaces social media channels. We also strongly recommend that anyone impacted by these deep fakes contact the NZ Police.
Thirdly, we wanted to comment on the extended prescription period from three to twelve months. This will have a positive impact for many people living with diabetes for a range of reasons. It remains important however that clinical decision making is the basis for selecting an appropriate prescribing period and the rationale is communicated clearly to tāngata whaiora to manage any concerns or expectations they may have.
Both the NZSSD executive and I are happy to take any further questions or feedback on these issues.
Ngā mihi,
Jo
Dr Jo McClintock (she/her)
Consultant Clinical Psychologist | Kaimātai Hauora Hinengaro
President - New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
Kia ora koutou
You may have seen the announcement from Pharmac this week about funding changes that will come into affect on 1 May 2025. .
Freestyle Libre 2 Plus CGM:
From 1 May 2025, Pharmac will be listing the FreeStyle Libre
2 Plus CGM as a standalone continuous glucose monitor (CGM) alongside the
currently listed FreeStyle Libre 2.
The FreeStyle Libre 2 Plus is more accurate than the previous model, it can
also be used for longer. The size, phone app, reader, adhesive, and application
method are the same as the FreeStyle Libre 2. Everyone who is currently
eligible for a funded FreeStyle Libre 2 will be able to switch to the FreeStyle
Libre 2 Plus.
The FreeStyle Libre 2 Plus can be worn for 15 days - a day longer than the
previous model. Because people can wear it for longer, Pharmac is changing how
many people can get on a prescription from 29 per year to 28 per year. This
aligns the FreeStyle Libre 2 Plus with other CGM's that we fund.
It will be available from 1 May 2025, and the currently funded FreeStyle Libre
2 will be delisted from November 2025.
Please pass this news onto your networks as I appreciate there will be a great
deal of interest in this change.
More information is on Pharmac's website
here.
Insulin Degludec with insulin aspart (Ryzodeg)
Pharmac is funding a new type of insulin (branded as Ryzodeg) for people with diabetes from 1 May 2025.
This is a mix insulin with a longer basal insulin combined with insulin aspart. As you know other mix insulins provided by Novo Nordisk have been phased out (PenMix and Mixtard) or will be in the near future (NovoMix) https://www.pharmac.govt.nz/medicine-funding-and-supply/medicine-notices/insulin
Ryzodeg will be an alternative option that may be beneficial for many people with T2DM.
Read the full details here:
The NZSSD Guidance group will be meeting in early May and will ensure all of our guidance documents are updated, with additional information about Ryzodeg.
Ngā mihi
Rosemary
Dr Rosemary Hall
Endocrinologist, Te Whatu Ora; Wellington and Tairāwhiti
President New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
Secretariat: Secretary@nzssd.org.nz
NZSSD website: www.nzssd.org.nz
Kia ora koutou
You may have seen the notice from Pharmac yesterday allowing new special authority applications for liraglutide (Victoza) from 1 March 2025. We are very pleased that the special authority criteria will be the same as when SA's were suspended in May 2024. This will again allow us to prescribe according to our national guidelines and best practice, and we all know how beneficial this will be for people living with diabetes. We are assured by Pharmac that the intention is for no further suspensions of special authority criteria for GLP-1 agonists to allow ongoing access for those who meet criteria. It is of course important, as previously, that these medications are prescribed only for people with T2DM so that availability continues.
The link to detailed information from Pharmac is:
Decision to enable new people to start treatment withliraglutide for type 2 diabetes
Unfortunately, we don't have such good news regarding the global shortage of Glucagon and the limited allocation to Aotearoa NZ.
Glucagon hydrochloride (Glucagen Hypokit): Supply issue
We will continue to keep you informed as more information becomes available.
Ngā mihi
Rosemary
Dr Rosemary Hall
Endocrinologist, Te Whatu Ora; Wellington and Tairāwhiti
President New Zealand Society for the Study of Diabetes
We know that this decision will also bring some anxiety for
our already stretched health system and workforce. NZSSD will provide as much
clinical and practical support as we can to enable the process to be as
streamlined and equitable as possible. We will keep you informed of education
opportunities and guidelines and welcome widespread discussion and resource
sharing.
I have attached our media release.
Pharmac's information page has details of the revised special authority criteria and processes around transitioning people from Medtronic systems.
|
Ngā mihi
Rosemary
Dr Rosemary HallEndocrinologist
President New Zealand Society for the Study of Diabetes
president@nzssd.org.nz
secretary@nzssd.org.nz
NZSSD website: www.nzssd.org
Please see the attached notice.
We suggest transferring people over to a new insulin well in advance of 30 September, to avoid any supply issues