Medsafe has opened a consultation on proposals to reduce barriers to accessing clozapine, a medicine used to treat treatment-resistant schizophrenia. These include reducing the blood monitoring requirements for people on clozapine treatment and widening prescribing to allow some pharmacists and nurse prescribers to take on this work.
The consultation is open to people taking clozapine, their family and caregivers, and healthcare professionals until 8 October 2025.
Clozapine is a medicine used to treat treatment-resistant schizophrenia. It is very effective but can cause significant side effects in some people.
The consultation follows a Medsafe review of the scientific literature and recent international guideline proposals.
Currently, people taking clozapine are required to have regular blood tests. This is because clozapine can cause a condition called neutropenia, which is when the number of white blood cells, called neutrophils becomes lower than normal. This increases the risk of severe infections. Currently these blood tests are required throughout treatment. However recent scientific research shows that it is possible to safely stop these tests after a period of time.
Data on the number of people taking clozapine shows that New Zealand has an effective system in place allowing patients access to clozapine. However, we recognise the requirement for regular blood tests may create a barrier to access for some people. The proposal suggests stopping blood monitoring, if the person taking clozapine has not had neutropenia, is able to self-manage their medical care, and is able to identify symptoms of infection and notify a healthcare practitioner if needed.
Changes to the blood monitoring requirements may also help people taking clozapine to have fewer interruptions to their treatment.
With some healthcare professions taking on greater responsibilities, the consultation also seeks feedback on which healthcare practitioners should be able to start people on clozapine treatment, and which practitioners should be able to issue subsequent prescriptions.
This includes allowing nurses and pharmacists, working in community mental health teams or under the supervision of a psychiatrist, to prescribe clozapine to patients who have already had their treatment initiated by a psychiatrist.
We encourage people taking clozapine, family members and caregivers, and healthcare professionals to have their say on these proposals. The link to the consultation can be found on the Medsafe website.
