Kaitiaki Hauora opposes Pharmac proposal to remove Māori and Pacific diabetes access protections
We have lodged a formal submission opposing Pharmac’s proposal to remove the Māori and Pacific access pathway for funded diabetes medicines including empagliflozin, liraglutide and dulaglutide.
While the proposal would lower the cardiovascular disease (CVD) risk threshold for some patients, the change should be added as an extra access pathway, not used to replace the current criterion for Māori and Pacific peoples.
The proposal risks undoing one of the few measurable examples of a health equity policy that has improved access to medicines for Māori and Pacific communities.
What is Pharmac proposing?
Pharmac is consulting on proposed changes to the funding rules for several type 2 diabetes medicines.
The proposal would:
remove the Māori and Pacific access pathway
lower the five-year cardiovascular disease risk threshold
retain other existing eligibility criteria
The consultation relates to funded access for:
empagliflozin
liraglutide
dulaglutide
Why does this matter?
Māori and Pacific peoples experience significantly higher rates of type 2 diabetes complications in Aotearoa.
Our submission notes that Māori with type 2 diabetes are:
twice as likely to die from cardiovascular disease
four times more likely to require dialysis
more likely to develop diabetes younger and experience serious complications earlier in life
The current pathway was introduced in 2021 after years of evidence showed Māori and Pacific peoples were not accessing these medicines at the same rates as other New Zealanders, despite having greater need.
Research published in the New Zealand Medical Journal later found the change significantly increased access for Māori and Pacific patients.
Why does Kaitiaki Hauora oppose removing the pathway?
The current pathway exists because many Māori and Pacific patients already face barriers getting healthcare in the first place.
The submission argues that replacing the ethnicity pathway with a lower cardiovascular risk threshold may simply move the barrier earlier in the process.
To qualify through the newly proposed pathway, patients first need access to regular primary care and to have completed cardiovascular assessments. But Māori and Pacific peoples are already less likely to receive those assessments due to barriers including:
the cost of GP appointments
difficulty accessing ongoing care
under-resourced health services
longstanding inequities within the healthcare system
Removing the pathway without evidence that similar access rates will be maintained raises serious concerns about whether the proposal aligns with the Crown’s obligations under Te Tiriti o Waitangi.
What is Kaitiaki Hauora recommending?
Kaitiaki Hauora is calling on Pharmac to:
Keep the Māori and Pacific access pathway in place
Lower the cardiovascular risk threshold as an additional pathway, not a replacement
Explore wider access options for all people with poorly controlled type 2 diabetes
Monitor prescribing rates to ensure Māori and Pacific access does not decline
Address inequities in access to cardiovascular assessments and primary care
Undertake and publish a formal Treaty analysis before making a final decision
How to make your own submission
Pharmac is currently accepting public feedback on the proposal.
You do not need to be a clinician or health expert to make a submission. Personal experiences of living with diabetes, accessing healthcare, paying for appointments or medicines, or supporting whānau are all relevant.
You may wish to comment on:
whether removing the pathway could create new barriers to access
whether the current healthcare system already provides equitable access
whether people who would benefit from these medicines are able to access them in practice
Submissions close at 5pm on Thursday 28 May. They can be short and written in plain language.
Aotearoa Diabetes Collective has built an easy to follow submission form here https://pharmacfeedback.netlify.app/
Or you can fill in the form on the Pharmac website here https://consultations.pharmac.govt.nz/medicines/2026-05-diabetes/ or email them your written submission to consult@pharmac.govt.nz