![\"\"](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/05\/IMZRDKAZZRCTJA2QQ3DP4UKFRQ.jpg\")
Photo: File. <\/p>\nProposed Pharmac changes to diabetes medicines are facing growing criticism from M\u0101ori health leaders and clinicians, who warn that removing ethnicity-based access criteria could deepen already entrenched health inequities for M\u0101ori and Pacific communities.<\/p>\n
Pharmac has opened consultation on proposed changes to the Special Authority criteria for several type 2 diabetes medicines, including empagliflozin, liraglutide and dulaglutide.<\/p>\n
Under the proposal, the cardiovascular risk threshold required to access the medicines would be lowered from a five-year risk of 15 per cent to 10 per cent.<\/p>\n
The proposal, however, would also remove the current eligibility pathway allowing M\u0101ori and Pacific patients to access the medicines without needing to demonstrate specific cardiovascular or renal complications.<\/p>\n
Associate Health Minister David Seymour and Health Minister Simeon Brown say the proposal would widen access and ensure treatment is based on \u201cclinical need, rather than ethnicity\u201d.<\/p>\n
\u201cEthnicity shouldn\u2019t decide what funded options you can access to manage type 2 diabetes,\u201d Seymour said.<\/p>\n
\u201cIf approved, Pharmac estimates that around 10,000 more people could benefit in the first year, increasing to around 23,000 people after five years.\u201d<\/p>\n
But M\u0101ori health organisations, pharmacists and diabetes experts say the changes risk dismantling one of the few targeted equity measures introduced to address longstanding disparities in chronic disease outcomes for M\u0101ori and Pacific peoples.<\/p>\n
Photo: File. <\/p>\n
Te Tirat\u016b, one of the country\u2019s largest Iwi M\u0101ori Partnership Boards representing more than 121,000 M\u0101ori, says the proposal could reverse years of progress aimed at improving access to life-saving medicines.<\/p>\n
Te Tirat\u016b co-chair, Glen Tupuhi, said M\u0101ori continue to experience significantly higher rates of diabetes, cardiovascular disease and chronic kidney disease, while also facing persistent barriers to accessing treatment.<\/p>\n
\u201cThese medicines save lives and prevent devastating complications for wh\u0101nau,\u201d Tupuhi said.<\/p>\n
\u201cM\u0101ori are diagnosed younger, become sicker earlier, and die sooner from preventable chronic illnesses. <\/p>\n
\u201cEquity pathways exist because the health system has not delivered equitable outcomes for M\u0101ori.\u201d he said. <\/p>\n
\u2018You just have to look in our urup\u0101 to see the impact\u2019<\/p>\n
Associate Professor Dr Ryan Paul, clinician and expert technical advisor to Te Tirat\u016b, said he was \u201creally gutted\u201d by the proposal, particularly given the success of the current pathway.<\/p>\n
\u201cWe fought to get it across the line, how welcomed it was by all the medical community and more importantly how successful it\u2019s actually shown to be,\u201d Paul said.<\/p>\n
Paul said the ethnicity criterion was one of five pathways enabling access to the medicines, but unlike the others, it helped overcome systemic barriers M\u0101ori and Pacific patients often faced within the health system.<\/p>\n
\u201cThe other criteria require other tests to be done and frequent visits. We know how hard that can be for our M\u0101ori, but also just within the health system, that\u2019s not done for M\u0101ori as much as done for non-M\u0101ori,\u201d he said.<\/p>\n
\u201cSo all of a sudden, what the ethnicity criteria did is it overcame those systemic barriers to accessing medications, which is likely why the ethnicity criterion was so successful [in] eliminating disparities in access to care.\u201d<\/p>\n
![\"\"](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/05\/6Q4R3XAJMNEBHFMVI7YIVAGCUQ.jpg\")
Photo: file. <\/p>\n
The current ethnicity-based criteria were introduced in 2021 following advocacy from M\u0101ori clinicians and researchers who argued M\u0101ori and Pacific patients were significantly less likely to receive newer diabetes medicines despite carrying a higher burden of disease.<\/p>\n
Dr Paul said M\u0101ori and Pacific peoples were two to three times more likely to develop type 2 diabetes, suffer complications and die from the condition.<\/p>\n
\u201cWe actually showed from our research that it reduced mortality in high-risk M\u0101ori and Pacific by fourfold,\u201d he said.<\/p>\n
\u201cThat\u2019s why we need to be fighting this because it was actually one of the most successful interventions we\u2019ve ever done for equitable care in Aotearoa.\u201d<\/p>\n
Diabetes Foundation Aotearoa chair Dr John Baker described the proposal as \u201ca great leap backwards\u201d, arguing the changes would make it harder for the communities most affected by diabetes to access treatment.<\/p>\n
![\"\"](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/05\/VLGO2F2ZG5ANNOJSVKEIILKMKE.jpg\")
Photo: Getty Images. <\/p>\n
Research following the introduction of the equity pathway in South Auckland showed a significant increase in prescriptions for Pacific patients after the criteria were eased.<\/p>\n
\u201cIt worked. And now they\u2019re reversing it,\u201d Baker said.<\/p>\n
\u201cThe likely outcome of this is that the European worried well who go to the doctor most often and complain the most will continue to get the medicines, and those who don\u2019t go to the doctors and who are really sick don\u2019t get it.\u201d<\/p>\n
Paul said while wider access to the medicines was welcome, the proposed replacement criteria could still create barriers for M\u0101ori and Pacific communities.<\/p>\n
\u201cFor those people to have a high cardiovascular risk over 10 per cent, often it may actually be too late to prevent loss of health or from a complication burden from their diabetes,\u201d he said.<\/p>\n
\u201cBut more importantly, we know that M\u0101ori and Pacific people do not have as many cardiovascular risk assessments as non-M\u0101ori. So as a result, once again introducing a barrier to care, which we know will cause inequity in outcomes.\u201d<\/p>\n
Te Tirat\u016b and M\u0101ori pharmacists are also raising concerns about whether the proposal aligns with Pharmac\u2019s Te Tiriti o Waitangi obligations.<\/p>\n
Associate Professor Leanne Te Karu, a claimant in the Waitangi Tribunal Health Services and Outcomes Inquiry, said restricting equitable access risks worsening what has previously been described as \u201cprescription inequity\u201d within the health system.<\/p>\n
Her research references the \u201cmissing million prescriptions\u201d analysis, which highlighted the scale of inequitable prescribing experienced by M\u0101ori relative to health need.<\/p>\n
\u201cRestricting equitable access to SGLT2 inhibitors and GLP-1 medicines risks widening the very inequities the health system has acknowledged for years,\u201d Te Karu said.<\/p>\n
Meanwhile, Ng\u0101 Kaitiaki o te Puna Rongo\u0101 o Aotearoa, the M\u0101ori Pharmacists\u2019 Association, says equity measures should not be removed before equitable outcomes are achieved.<\/p>\n
Tumuaki Mariana Hudson said universal thresholds may appear fair on paper, but M\u0101ori do not experience the health system in the same way as other populations.<\/p>\n
\u201cI would strongly encourage Pharmac to undertake and publicly share robust M\u0101ori-specific equity impact analysis before progressing these changes,\u201d Hudson said.<\/p>\n
\u2018Need over race\u2019 – Seymour ![\"\"](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/05\/Q2KMFOA4HRGBHM6UYLZBT5HHUM.jpg\")
Deputy Prime Minister David Seymour. Photo: Hagen Hopkins\/Getty Images. <\/p>\n
\u201cPeople should be getting medicines based on their need rather than their race,\u201d Seymour told Te Ao M\u0101ori News when asked about M\u0101ori health leaders concerns. <\/p>\n
\u201cNo matter what your ethnic background, if you have the markers of need, then you will get access.\u201d<\/p>\n
Seymour said decisions should focus on the underlying risk factors.<\/p>\n
\u201cSometimes you will find, for example, that because the M\u0101ori population is younger there\u2019ll be greater need for a disease that hits people when they\u2019re younger,\u201d he said.<\/p>\n
\u201cHowever, the right way to do that is just give it to all young people, then you\u2019ll catch M\u0101ori too.\u201d Seymour said.<\/p>\n
The consultation closes on May 28.<\/p>\n","protected":false},"excerpt":{"rendered":"Proposed Pharmac changes to diabetes medicines are facing growing criticism from M\u0101ori health leaders and clinicians, who warn…\n","protected":false},"author":2,"featured_media":438140,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[23067,3535,134,19160,50521,111,139,69,19953,69397],"class_list":["post-438139","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-david-seymour","tag-diabetes","tag-health","tag-health-equity","tag-iwi","tag-new-zealand","tag-newzealand","tag-nz","tag-pharmac","tag-simeon-brown"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/438139","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=438139"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/438139\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/438140"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=438139"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=438139"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=438139"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}