Review of the Exceptional Circumstances Framework

Overview

Pharmac is reviewing its Exceptional Circumstances Framework (the Framework) after people told us it needs to work better and is hard to understand. 

The Framework includes the Named Patient Pharmaceutical Assessment (NPPA) policy and other ways Pharmac can fund medicines for individuals in special or exceptional clinical situations.

The Discussion Document

You can read the full text of the 'Review of the Exceptional Circumstances Framework Discussion Document' on our website.

You can download a PDF version of the 'Review of the Exceptional Circumstances Framework Discussion Document' to review offline.

Or you can download a PDF version of 'Review of the Exceptional Circumstances Framework - questions'
if you'd like to complete a hardcopy version.

Speech to text

To use the speech-to text-option when giving answers, you will need to allow access to your microphone. 

Want to give feedback in another way?

Online forms don't work for everyone. We are keen to make sure we gather everyone's feedback. For example, if you want to record a video, just record it, load it to an online service, and send us the link. 

For more ways to provide feedback, check out our engagement approach. You can also call or email if you’d like to talk through other options.

Frequently asked questions (FAQ)

You've asked us questions about the Framework and this review. We've colated them on our website. 

Read the FAQs

What happens next

Review is on-going

This consultation may have closed, but we are still keen to hear from you. If you have any questions, you can email the review team:

ECFReview@pharmac.govt.nz

Timeline for the review of the Exceptional Circumstances Framework

Stage

Key Steps

Estimated Time

Public consultation on discussion document
  • Start consultation
  • Discussion document on website
  • Feedback methods established and set up

Consultation was open for 12 weeks.
(Closed 7 June 2026)

Submissions analysis
  • Summarise submissions received. Follow up with stakeholders on their submissions as necessary (for example, clarifications).
  • Post information gathered on submissions received on Pharmac’s website.

8 weeks

Drafting proposed changes paper
  • Draft paper, which includes Pharmac preferred option/s and implementation considerations.
  • Internal consultation on draft paper including approval from SLT.

4 weeks

Public consultation on proposed changes paper
  • Meet with key stakeholders and submitters
  • Release of a proposal paper
  • Consultation and feedback

8 weeks

Submissions analysis and draft documents final decision
  • Summarise submissions received. Follow up with stakeholders on their submissions as necessary (for example, clarifications).

10 weeks (note: Pharmac closed for 2 weeks over Christmas/New Year)

Final decision
  • Decision paper for SLT and Board
  • Aim for Board Paper in March 2027
  • Announcement of decision by Pharmac.

10 weeks

Closed 7 Jun 2026

Opened 17 Mar 2026

Contact

ecfreview@pharmac.govt.nz

Audiences

  • Family/whānau of someone who uses medicines
  • Friend of someone who uses medicines
  • Other health care professionals
  • Other member of the public
  • Person who uses medicine
  • Pharmacists
  • Prescribers
  • Representative of a consumer group
  • Supplier
  • Wholesaler