Change in special authority criteria for diabetes medicines
Published: 12 August 2026
By removing the requirement to have high cardiovascular or renal risk to access these agents, and shifting the focus primarily toward HbA1c control and standardized treatment pathways, PHARMAC are making these medications available to more people.
The changes to access for diabetes medicines come into effect from September 1st 2026 when the special authority will change to the following:
For Empagliflozin (Jardiance) and empagliflozin combined with metformin (Jardiamet):
Type 2 Diabetes
Target HbA1c (of 53 mmol/mol or less) has not been achieved despite the regular use of at least one blood-glucose lowering agent (e.g. metformin, vildagliptin, or insulin) for at least 3 months;
Patient has previously had an initial approval for a GLP-1 agonist and is changing funded treatment to an SGLT2i
For dulaglutide (Trulicity) and Liraglutide (Victoza)
Type 2 Diabetes
Target HbA1c (of 53 mmol/mol or less) has not been achieved despite the regular use of all the following blood-glucose lowering agents for a period of at least 6 months, where clinically appropriate*: empagliflozin, metformin and vildagliptin
*Consider the side effects of empagliflozin with a very high HbA1c (specifically the risk of DKA and urogenital infection) when deciding what is clinically appropriate.
Existing Patients: Patients currently receiving funded treatment under the old criteria (e.g., those with established cardiovascular disease) will continue to have their funding maintained; they do not need to meet the new HbA1c-based criteria.
Documentation: Ensure clinical notes reflect the trial of the required agents (metformin/vildagliptin/empagliflozin) for the specified duration before applying for GLP-1 funding.
Heart Failure Exception: The rule prohibiting co-prescription of SGLT2 inhibitors and GLP-1 agonists does not apply if the SGLT2 inhibitor is indicated for heart failure, regardless of the patient's diabetes status.
Read the full decision here Decision to widen access for type 2 diabetes medicines - Pharmac | Te Pātaka Whaioranga | NZ Government
For more information or guidance, contact the Pinnacle Clinical Diabetes Specialist in your locality.