The Diabetes Foundation is accusing Pharmac of 'penny pinching' on drugs used in other countries and says hundreds of New Zealanders will die earlier than they should as a result.
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Pharmac announced on Monday it will fund two new medicines, Empagliflozin and Dulaglutide, for those who are at high risk of heart and kidney complications from type 2 diabetes.
It also widened its criteria so that Māori and Pacific people with diabetes can have better access to the drugs - the first time it has specifically included ethnicity as a criterion, saying it's an "intentional, proactive move to address" inequitable access to medicines and healthcare among those groups.
However, the Diabetes Foundation said an early death was certain for four out of every five diabetics ineligible for the medicines.
Diabetes Foundation Aotearoa chairperson Dr John Baker, an endocrinologist at Middlemore Hospital, has been a long-term advocate of the medicines and told Morning Report they were now standard care in every western country.
Baker said the two outcomes to be most concerned about in diabetic care were premature death - people with diabetes have the same risk of a heart attack or stroke as someone who has already had a heart attack without diabetes - and the second risk was the progression to end-stage kidney failure and dialysis.
Clinical trials established a 40 percent drop in death rate with both drugs and a 15-year delay in progression to kidney failure with the first drug, he said.
Dr John Baker Photo: LDR / Stephen Forbes
"This is a must-have for every other Western country in the world."
While Pharmac secured the drugs at the best prices, they were having to be "rationed' because of its limited budget, he said.
Dr Baker estimated it would cost about $25 million to $50m a year to fund all type-2 diabetics, which he said was not a lot of money for 250,000 New Zealanders.
Pharmac noted that the population who could benefit from the drugs would likely represent a wider group than just type 2 diabetics.
While he welcomed Pharmac's decision to widen access and eligibility for Māori and Pasifika and agreed it would be a significant step in addressing inequitable health outcomes, Dr Baker said they were not the only high risk group.
"People are going to miss out and that's my beef with it all."
Diabetics who were not eligible for having the drugs funded could buy either drug for about $90 a month, but Pharmac's buying power meant they could get it much cheaper, he said.
"That's a particular gripe for me - why poor people have to pay $90 a month when Pharmac gets it for a quarter of that."
Thought given to more widespread funding - Pharmac
Pharmac said it received feedback from about 60 different people, professional societies and advocacy groups while considering whether to fund the new drugs.
It said it considered making the drugs available to all type 2 diabetes patients, but decided extra money would be more valuable if it was spent on other higher priority medicines.
However, it widened access and eligibility to the drugs to specifically include Māori and Pacific patients; people who had not responded to other treatments whether or not they developed diabetes as a child; and it widened the assessment of cardiovascular risk from pre-existing to a 'high lifetime risk'.
It said Pharmac had a role to play - along with others - in improving equal access to healthcare.
Health Minister Andrew Little confirming this week the government intended to carry out an independent review of the organisation, as Labour promised leading up to the election.
