Patients with diabetes charged for 'free' devices

• Patients with diabetes charged for "free" monitors
• Some pharmacists losing money on devices due to funding shortfall
• Pharmac says there is "sufficient supply" but it's not evenly distributed
• Health NZ insists pharmacists should not be charging extra fees for funded drugs and devices

Some people with diabetes have been charged for their "free" continuous glucose monitors, which have been fully government-funded since 1 October.

But pharmacists argue funding does not always cover the cost of supplying the products, which track blood sugar levels without the need for painful, repetitive finger pricks.

Auckland man Bradley Dewhurst - who has type 1 diabetes - said there had been been multiple problems with the rollout of the funded continuous glucose monitors (CGMs).

He got his first prescription for a fully funded device on 2 October, the day after they became available.

"By 9am that day, my pharmacist was saying that was the only sensor they were actually able to source. Everything else was out of stock.

"And I know there are still people who are being told that it will be mid November before they are able to get a supply."

Some patients reported being charged $50 for a three-month supply of sensors, which usually last one or two weeks.

Dewhurst said family doctors received no information or training following the initial announcement.

"I know I'm not the only person whose GP did not know how many they were supposed to be prescribing at a time, and ended up with a prescription for a single sensor as a three-month supply."

The government's drug-funding agency Pharmac put a public statement on its website last week, acknowledging the supply chain delays and asking people to be "patient".

It also advised that patients should not be asked to pay additional fees on top of the usual $5 prescription charge.

Pharmacies losing money on devices

Pharmacy Guild chief executive Andrew Gaudin said due to a "quirk" of the funding system, some smaller community pharmacies were losing money on some products because they were unable get bulk discounts from wholesalers.

"It just so happens that if you don't have the volume of activity, you can be out-of-pocket for these products. And that's before they've even dispensed and provided the advice to the patient."

The shortfall could be $5 - $20 per item, he said.

This mismatch between the funding from Health New Zealand and what wholesalers were charging was "not unique" to continuous glucose monitors.

"It's part of a wider supply chain funding model issue, so it's not new.

"We want to get it sorted out."

The Pharmacy Guild is currently in the process of negotiating its annual contract with Health New Zealand, with the most recent meeting last Monday, and is seeking to have the funding model overhauled.

Gaudin said when it came to CGMs, even sourcing supplies had been challenging with the initial rush of demand.

"Pharmac is now providing an assurance that there is sufficient stock around the place, but it's somewhere between the various wholesalers, the pharmacies and the suppliers.

"So you've got to find where the product is in the supply chains."

Dewhurst, who was among many patients and advocates to lobby Pharmac to fund CGMs, estimated he had spent $8000-$10,000 on his life-saving device in the past four years.

His critique of Pharmac's cost-benefit analysis - based on documents obtained under the Official Information Act - suggested the agency was only taking into account the cost of glucose strips and hospitalisations for low-blood sugar, not the wider costs of diabetes to the health system and individuals.

The agency apologised after it was revealed that one official suggested "lazy" people would rely on CGMs to track their blood sugar rather than do finger pricks, which suggested they fundamentally misunderstood the device, Dewhurst said at the time.

"I consider myself fortunate to have been able to carry this cost myself, but obviously it's a cost that I'm glad I'm not having to pay directly any more."

Pharmacies cannot charge extra fees, says Health NZ

In a written response to RNZ, Health New Zealand director living well Martin Hefford said all CGMs listed on the Pharmaceutical Schedule were fully funded for those who met the eligibility criteria.

"Under the service contract between Health New Zealand and community pharmacy providers, community pharmacies should not be passing on additional costs for fully funded medicines or devices to patients."

Te Whatu Ora contracts with more than 1000 community pharmacies throughout New Zealand to provide pharmacy services to all New Zealanders, he said.

"Health NZ met with pharmacy provider representatives this week as part of the 2024 National Annual Agreement Review for the Integrated Community Pharmacy Service Agreement (the national community pharmacy contract between Health NZ and each community pharmacy).

"These discussions are ongoing and a range of issues were canvassed. At this stage there is no outcome to share."

Pharmac spokesperson Adrienne Martin said more than 11,000 people had been approved funding for continuous glucose monitors within the first month.

"We had expected 12,000 people would choose to access these in the first year so it's great to see people are getting the products they need."

The demand had put "some pressure" on supply, but there was stock available, and Pharmac continued to monitor levels held by wholesalers and suppliers, she said.

"Stock needs to move through the supply chain from wholesalers and then to pharmacies. Sometimes there are small delays to get stock to pharmacies.

"We appreciate people want to access their CGMs as soon as possible. We encourage people to keep in touch with their pharmacies and be patient."

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