Proposal to fund medicines for people with high blood pressure and bacterial infections
Bedaquiline and linezolid for non-tuberculosis mycobacteria infection
What would the effect be?
From 1 November 2026, funded access to both bedaquiline and linezolid would be widened to support treatment of people with non-tuberculous mycobacterial (NTM) infections.
While both bedaquiline and linezolid are used for the treatment of NTM infections, please note these are separate treatments which can be used individually.
We estimate that, over the next 5 years, about 5-13 people per year would receive bedaquiline or linezolid for the treatment of NTM infections.
About non-tuberculous mycobacterial infections, bedaquiline and linezolid
Non-tuberculous mycobacteria (NTM) are a group of bacteria found naturally in the environment that can sometimes cause serious infections, particularly in people with underlying lung disease or weakened immune systems. These infections can be difficult to treat because the bacteria are often resistant to many commonly used antibiotics. Without effective treatment, NTM infections can lead to persistent infection, worsening respiratory symptoms, and permanent lung damage.
Bedaquiline and linezolid are antimycobacterial medicines used as part of combination treatment regimens for some difficult-to-treat NTM infections. Bedaquiline works by inhibiting an enzyme needed by mycobacteria to produce energy. Linezolid is an antibiotic that prevents bacteria from producing proteins they need to grow and survive.
Why we’re proposing this
Pharmac currently funds bedaquiline and linezolid through the NPPA pathway for a small number of people with NTM infections. These patients are generally managed by specialist infectious disease services and often have infections that are resistant to multiple treatment options.
We are proposing these changes because they would formalise existing access through the Pharmaceutical Schedule, making funding arrangements more transparent and enabling people to access treatment more easily.
Details about our proposal
From 1 November 2026, new Special Authority criteria would be added for bedaquiline and linezolid for non-tuberculous mycobacterial infection as follows:
Bedaquiline
Initial application — non-tuberculosis mycobacteria (NTM)
Applications from any relevant practitioner. Approvals valid for 12 months.
- The person has non-tuberculosis mycobacteria (NTM) infection
- Ministry of Health’s Tuberculosis Clinical Network has reviewed the individual case and recommends bedaquiline as part of the treatment regimen
Linezolid
Initial application — non-tuberculosis mycobacteria (NTM)
Applications from any relevant practitioner. Approvals valid for 12 months.
- The person has non-tuberculosis mycobacteria (NTM) infection
- Ministry of Health’s Tuberculosis Clinical Network has reviewed the individual case and recommends linezolid as part of the treatment regimen
Similar changes would be made to the hospital medicines list restriction for bedaquiline. Linezolid is already funded in hospital requiring only the recommendation of an infectious disease clinician or use in line with the hospital’s guideline.