PHARMAC has put the brakes on two new medications that would greatly improve treatment options for Type 2 diabetics, frustrating The Royal New Zealand College of General Practitioners.
There are 220,000 New Zealanders living with Type 2 diabetes, and an estimated 11 per cent of the health budget goes towards treating the disease each year. Māori are affected three times as often as Pākehā patients, and Pacific people five times as often.
PHARMAC recently consulted on two entirely new medications - empagliflozin (Jardiance) and dulaglutide (Trulicity), to be introduced from 1 December 2020, but then abandoned the idea pending more consideration.
Dr Bryan Betty (pictured left), Medical Director of The Royal New Zealand College of General Practitioners, and a practicing GP in Cannons Creek East Porirua, with a significant number of diabetic patients, says, "New Zealand’s statistics are dreadful, complications are affecting Māori and Pacific people at a younger age, and we’re five to 10 years behind the rest of the Western world in access to medications.
"These new medications have substantial advantages in that they typically lead to weight loss, do not cause hypoglycemia, and protect against cardiovascular and renal disease independently of their effects on glucose levels. We are 5-10 years behind the rest of world with access to these medications and cannot delay further; New Zealanders deserve these treatment options.
"Type 2 diabetes is a significant contributor to poor health in Māori and Pacific communities and to limit the availability of improved medication options, like PHARMAC has done, has major equity considerations and consequences," says Dr Betty.
In addition to greater numbers of people being diagnosed with Type 2 diabetes, those diagnoses are coming at a younger age. This brings its own set of issues because major complications arise on average 20 years after onset, so a patient diagnosed at the age of 30 will face major health issues by the age of 50, including heart disease, amputation, and end-stage renal failure, life changing for both patients and whānau.
"The younger they are, the greater the health impact, which is why it’s so frustrating to have access to new, better medications effectively taken away.
"Māori and Pacific patients are seven to 12 times more likely to progress to end-stage renal failure compared with Europeans and that needs to improve," says Dr Betty.
Escalating rates of end-stage renal failure, particularly in Māori and Pacific patients, are costing $100,000 a year per patient, with an average survival rate of only five years.
"Anything we can do to halt these outrageous statistics will be significant and we believe the new PHARMAC medications would have given us a fair shot at that," says Dr Betty.
PHARMAC needs to return empagliflozin (Jardiance) and dulaglutide (Trulicity) to the table so that GPs can get their patients onto more effective treatment options and improve the lives of our most vulnerable communities.