Waikato University researchers have found Pharmac's 2021 decision to introduce ethnicity criteria on game-changing diabetes drugs has helped improve inequities in our healthcare system for Māori and Pacific people.
The team, led by Te Whatu Ora endocrinologist and University of Waikato Senior Lecturer Dr Ryan Paul (Ngāti Maru, Hauraki), said Pharmac should now consider rolling out ethnicity criteria for all medications.
"This is a huge turnaround, as many Māori and Pacific patients were not getting the glucose-lowering therapies they needed despite multiple contacts with the health system," Dr Paul said.
Pharmac's ethnicity criteria for Māori and Pacific people was controversial when it was brought in in 2021 for heart drugs, lung cancer, breast cancer and type 2 diabetes medicines Jardiance and Trulicity.
But those at the coal face said New Zealand had little choice.
"Māori people are twice as likely to die from cardiovascular disease brought on by diabetes, and four times more likely to end up on dialysis and those figures are shockingly worse for Pacific people."
Waikato University set out to find out how effective the Pharmac ethnicity criteria has been since its introduction, given type 2 diabetes costs the country more than $2 billion annually.
The incidence of type 2 diabetes in the population is predicted to increase, with one in four Pacific people predicted to have the disease within 20 years. It also leads to about 600 amputations each year.
Hamilton woman Vanessa Johnson, 58, is Māori and has been injecting herself with Trulicity since the Pharmac decision in 2021 to dispense the medication under a 'special authority criteria' (SAC).
"I'm more fit than I've ever been. I can walk around properly and I can see- it's helped me a lot," said Johnson.
She said many Māori and Pacific people wouldn't otherwise afford Trulicity and she welcomes the University's call to roll out ethnicity criteria across more medications.
Her father had diabetes and died, as did a cousin. She thinks their outcomes would have been different if they got the support and drugs she is getting.
"We know in the past prescribers like GPs often haven't traditionally prescribed for Māori and Pacific people. Often they present with multiple health problems or go to the GP for an infection or a flare-up of their gout - diabetes just doesn't get looked at," said Dr Paul.
His research suggests around 40 percent of Māori and Pacific people with diabetes, renal or heart disease are now on Trulicity or Jardiance since the introduction of the ethnicity criteria.
"All other ethnicities, if they are high risk, still have access to the medication," he said.
But he thinks the special authority criteria "likely heightened awareness amongst prescribers and patients asking for it", hence the uptake by Māori and Pacific people.
Dr Paul told Newshub that based on overseas experience, "for every 18 people treated who are high risk, one death will be prevented every five years" by having ethnicity criteria.
Pharmac chief Māori advisor Trevor Simpson said Pharmac is watching the University of Waikato's research with interest.
When asked whether Pharmac would introduce ethnicity criteria on all medications, he said: "We are not ruling out we will do this again at some stage, we are just watching what emerges from our current use of ethnicity criteria for Diabetes medications."
Waikato University senior lecturer Dr Paul said the next step will be to assess if there has been a reduction in mortality, hospitalisations, and GP and clinic visits.
