Key Takeaways:
- The New Zealand government has reversed its decision to charge a $5 co-payment fee every three months for 12-month prescriptions, instead opting for a single $5 fee for the entire year.
- The change aims to reduce the cost of seeing GPs and accessing medicines for patients with long-term conditions.
- The decision is expected to reduce the cost to patients by up to $15 over the course of a 12-month prescription.
- The move is part of a broader effort to improve access to medicines and reduce financial barriers for New Zealanders.
- The change will take effect on February 1, 2026, and will apply to patients collecting their initial three-month supply of medication.
Introduction to the Policy Change
The New Zealand government has made a significant u-turn in its policy regarding 12-month prescriptions, announcing that patients will only need to pay a single $5 co-payment fee for the entire year, rather than every three months. This change, which was revealed in a series of Health Ministry documents released just before Christmas, is a major reversal of the government’s initial decision, which was announced as part of the 2025 Budget. The initial decision would have required patients to pay a $5 fee every three months, but the government has now decided to scrap this plan and instead opt for a single payment at the start of the 12-month period.
Background to the Decision
The decision to introduce 12-month prescriptions was made in May, ahead of the 2025 Budget, as a way to reduce the cost of seeing GPs and accessing medicines for patients with long-term conditions. However, the initial plan to charge a $5 co-payment fee every three months was seen as a potential barrier to access, with around 191,000 adults in 2023/24 not filling a prescription due to the cost. In response to this, Health Minister Simeon Brown recommended changing the policy to remove the additional co-payment fees, citing the need to reduce costs to patients and improve access to medicines. The Cabinet committee agreed with this recommendation on September 17, and the decision was confirmed on September 22.
Impact of the Decision
The change in policy is expected to have a significant impact on patients, particularly those with long-term conditions such as asthma, diabetes, epilepsy, and high blood pressure. By removing the additional co-payment fees, the government hopes to reduce the cost to patients by up to $15 over the course of a 12-month prescription. This will make it easier for patients to access the medicines they need, without being deterred by the cost. The decision is also expected to reduce complexity for Health New Zealand, which will no longer need to process multiple co-payments for each patient. However, the change will result in extra yearly costs to Health NZ of between $6 million and $23 million, which is expected to grow by around 5 percent each year.
Reaction to the Decision
The decision has been welcomed by the Pharmacy Guild, which represents community pharmacies across New Zealand. Chief executive Andrew Gaudin described the change as a "great thing" that would ensure more affordable access to medicines for patients. He also welcomed a separate decision to "fully mitigate" a planned reduction in the fee paid to pharmacists for dispensing services, which would have had a negative impact on community pharmacies. However, some pharmacists have expressed concerns that they may not be ready to take on new prescribing responsibilities, which are also part of the government’s plans to improve access to medicines.
Implementation of the Decision
The change in policy will take effect on February 1, 2026, and will apply to patients collecting their initial three-month supply of medication. Health New Zealand is working with the primary care and community pharmacy sectors to support implementation, with the Ministry of Health and Pharmac also supporting the rollout. The government has instructed the Health Ministry to get the policy ready to take effect by the start of February, and patients can expect to see the changes in practice from then. Overall, the decision is a significant step forward in improving access to medicines and reducing financial barriers for New Zealanders, and is expected to make a real difference for people managing long-term conditions.