Pharmac is currently reviewing its Exceptional Circumstances Framework, which is the system used to consider funding medicines for individuals in special or unusual clinical situations outside the normal funded pathways. This includes processes like the Named Patient Pharmaceutical Assessment (NPPA).
The review has been prompted by feedback that the current system can be complex, difficult to understand, and inconsistent. The aim is to make it simpler, clearer, more transparent, and more equitable, while still ensuring decisions align with Pharmac’s legislation and fixed medicines budget.
The review looks at how the whole framework operates, including NPPA and other exception pathways, and aims to improve:
- Clarity around when and how to apply
- Transparency of decision-making
- Equity of access for people with high or complex health needs
- Consistency in how applications are assessed
- How discretion is used in decision-making
Consultation and Feedback Process
Pharmac is running a two-stage consultation process, where feedback will help shape proposed changes before final decisions are made.
Feedback closes 15 June.
How to give feedback / submit a response
You can submit feedback in several ways:
- Inform MSNZ of the challenges you have faced to feed into our national submission: Complete MSNZ feedback form here.
- Online feedback form direct to Pharmac: https://consultations.pharmac.govt.nz/policy/exceptions-framework/
- Email: ecfreview@pharmac.govt.nz
(You can choose more than one option to make sure your voice is heard!)
Want to know more?
Pharmac are running 2 consumer-focused online sessions where they will explain the review, talk through how the framework works, and answer questions:
- Friday 22 May, 10:00–11:00am (tomorrow). Please register here to receive the meeting link.
- Tuesday 2 June, 6:30–7:30pm. Please register here to receive the meeting link
Last Updated May 21, 2026