How a medication is approved and funded
Medicines need certain government approvals to become accessible in New Zealand.
First, Medsafe evaluates new medicines and recommends whether they’re safe to be used in New Zealand. Medsafe is part of the Ministry of Health. It’s responsible for the regulation of therapeutic products in New Zealand, but not for funding or purchasing medicines.
Unfunded medicines are usually expensive and inaccessible for many people.
Pharmac is the government organisation responsible for deciding which medicines will be publicly funded. Pharmac receives advice from the Pharmacology and Therapeutics Advisory Committee (PTAC) to help Pharmac make decisions about how to use its funds.
Pharmac receives about 85 applications each year to fund different medicines and related products. Find out more about Pharmac’s process here
Availability of CGRP monoclonal antibodies in New Zealand
Medsafe has approved three CGRP monoclonal antibody medications: Aimovig (erenumab), Emgality (galcanezumab) and Ajovy (fremanezumab). Aimovig and Emgality are available on prescription from your GP or neurologist. Ajovy is not yet available. Emgality became available in New Zealand in August 2022.
A consumer application was made to Pharmac to fund Aimovig in February 2021, before Migraine Foundation Aotearoa New Zealand was founded. In November 2021, PTAC recommended Aimovig be funded with low priority. You can read a summary of PTAC’s meeting and the feedback we submitted post their feedback here.
The funding of Aimovig is now under consideration by Pharmac, using its Factors for Consideration framework. The four factors for consideration are need, health benefits, costs and savings and suitability. Pharmac is not transparent about how much weight is given to each factor.
The issue with unfunded medications
Because Aimovig and Emgality are unfunded, they’re expensive and inaccessible for many whose lives could improve with these medications. People with migraine in Aotearoa New Zealand deserve funded access to preventive medications that are safe and effective.
Migraine Foundation Aotearoa New Zealand want Emgality funded in New Zealand. We submitted a consumer application to Pharmac in November 2022, requesting funding for people with chronic migraine (headache on 15 days or more with at least eight of these headache days having features of migraine, lasting for more than three months), who have not responded to three other preventive medications.
Why just chronic migraine? When Pharmac reviewed the consumer application for Aimovig, which requested funding for both episodic and acute migraine, it recommended that Aimovig be funded (with a low priority) only for people with chronic migraine and who had unsuccessfully tried three preventive treatments. While we would like to see broader funding of Emgality, we think that initially seeking funding only for chronic migraine targets the greatest need and will have a greater chance of success.