Māori and Pasifika are at greater risk of developing type 2 diabetes.
Photo: LDR / Supplied
A diabetes organisation is worried about the possible impact of a Pharmac proposal to remove ethnicity as a criteria for several type 2 diabetes drugs.
Māori and Pasifika are at greater risk of developing type 2 diabetes, and in 2021 it was decided to prioritise access to these patients.
Now Pharmac is asking for feedback on changing the Special Authority access. It would reduce the required level of cardiovascular risk for those with type 2 diabetes from 15 to 10 percent, but also remove the criteria allowing Māori and Pasifika access without having to demonstrate specific cardiovascular or renal risk factors.
Health Minister Simeon Brown and Associate Health Minister David Seymour said when people can access their medicines easily, they stay healthier for longer.
John Baker is chair of the Diabetes Foundation Aotearoa and an endocrinologist at Middlemore Hospital. He says the proposal feels like a great leap backwards.
Associate Health Minister David Seymour.
Photo: RNZ / Samuel Rillstone
“I don’t know why the ministers have decided to go down this path. I mean, there’s no logic to it, really,” he told Nine to Noon on Friday.
The problem with that, he says, is the “other people” will access the drugs based on a probability of cardiovascular risk – not the proven increased likelihood Maori and Pacifika have of developing diabetic kidney disease.
Approximately one in 12 Māori have diabetes, and for Pacific people it is one in seven – compared to roughly one in 20 Pākehā, co-chair of Mahitahi Matehuka (National Diabetes Network) Dr Ryan Paul told RNZ earlier this week.
Baker said there were other drugs that targeted cardiovascular risk, but the medicines affected by the proposed change – empagliflozin, empagliflozin with metformin, dulaglutide and liraglutide – are “the first drugs which have been shown specifically to impact on diabetic kidney disease”.
Pharmac says the changes would widen access for the greater population, with 23,000 more people accessing the drugs in five years’ time.
“The effect of the change that they’re proposing is that the drugs will be given to people who don’t have a risk of diabetic kidney disease,” Baker said. “And that doesn’t make sense… given that there are other drugs we can use.”
Consultation on the proposal closed next week.
In a response to criticism of the changes, Seymour said Kiwis “shouldn’t miss out [on medicines] because of where their ancestors came from”.
“If this proposal is approved, around 10,000 more people are expected to benefit from these medicines in the first year, increasing to around 23,000 after five years. We expect that around a third of those people will be from Māori or Pasifika backgrounds.”
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