Who is eligible
To be eligible for transitional access, patients must either:
- be receiving private treatment with the cancer medicine at the time Pharmac begins its public funding; or
- start treatment with the newly funded medicine in a private facility within 31 days of the public funding start date.
In addition, the private facility managing the treatment must be approved by the Ministry of Health (see provider eligibility section).
How long does coverage last
Patients can access the publicly funded cancer medicine in private facilities for 12 months from the date funding begins. This timeframe allows most patients to complete their treatment.
For those who need long-term or ongoing treatment, the 12-month period provides time to transfer their treatment management to a Health NZ hospital, should they wish to continue to access the specific publicly funded cancer medicine.
Example: If a cancer medicine is funded on 1 August, patients could access publicly funded cancer medicines in private facilities until 31 July the following year, provided they were already in treatment on 1 August, or started treatment prior to 31 August.
Publicly funded cancer medicines must be used in line with the criteria set by Pharmac in the Pharmaceutical Schedule, including clinical requirements like treatment stage. These rules apply to all patients, whether treated in public or private facilities.
