Pharmac is widening funded access to tocilizumab, an immunosuppressive drug used mainly to treat arthritis, to treat moderate to severe cases of covid-19. This is an off-label use of the drug.
Prescribers will not have to make applications to Pharmac for tocilizumab to be funded for treatment of covid-19 for each individual patient, as they have been doing up until now, says Pharmac in a media statement.
“Studies have shown tocilizumab may help hospitalised covid-19 patients, reducing severity and time in hospital,” says Pharmac’s director of operations Lisa Williams.
Pharmac has already funded tocilizumab for more than 30 patients for treatment of covid-19. The majority of these patients are as a result of the current community outbreak being managed.
“While it is ultimately our role to decide which medicines are publicly funded for Kiwis, we work with a lot of external experts when making these tough decisions. We’re guided by robust evidence and the expertise of clinicians and the healthcare sector,” says Williams.
“We made the decision to widen funded access to tocilizumab for treatment of covid-19, after a targeted consultation with DHBs, the Ministry of Health, and its supplier (Roche NZ). We also spoke with rheumatologists who manage currently funded patients, and health care professionals involved in the treatment of covid-19.
“Our experts were supportive of Pharmac funding tocilizumab for use in the treatment of covid-19,” says Williams.
Following Pharmac’s initial consultation – but prior to making the final decision to fund tocilizumab for covid-19 – Roche NZ advised its would not be able to supply our contracted tocilizumab to New Zealand for three months from October.
“Our clinical experts have told us that priority patients are those who are currently using tocilizumab and who are at high mortality risk without treatment, as well as people hospitalised with moderate to severe covid-19,” says Williams.
“We are working closely with Roche NZ, and DHB hospitals, to help manage stock to ensure there is sufficient supplies of tocilizumab to maintain treatment for priority patients during the gap in supply (October 2021 – January 2022). We are also funding a new alternative treatment for those with rheumatoid arthritis called upadacitinib.”
From 1 October 2021, access to tocilizumab for covid-19 will be via funding restrictions in the Pharmaceutical Schedule. This means prescribers will no longer need to apply directly to Pharmac for each of their patients. This will reduce the administrative burden and help to ensure patients receive timely treatment.
As tocilizumab is not currently Medsafe approved for use in the treatment of covid-19, this means that use of tocilizumab for covid-19 patients will need to comply with Section 25 of the Medicines Act 1981.
“We all know that our best defense against covid-19 is to get vaccinated. But we are pleased that we can fund a treatment to help those who do require hospitalisation as a result of this infectious disease,” says Williams.
This funding is not coming from Pharmac’s Combined Pharmaceutical budget but from the covid-19 fund. The Government has provided this fund to support the additional cost of medicines as a result of covid-19.