Changes to funded access to antiretroviral medicines from 1 November 2026
Kia ora.
Following significant consultation and engagement, Pharmac is making changes to the Pharmaceutical Schedule relating to antiretroviral medicines used in the treatment and prevention of HIV.
What is changing
Removal of Special Authority requirements:
From 1 November 2026, there will no longer be a Special Authority requirement for funded antiretroviral treatment for any indication.
The removal of Special Authority requirements is intended to reduce administrative burden. It does not change expectations regarding the clinical management, monitoring, or specialist involvement in the care of people living with HIV.
It remains the responsibility of the prescribing clinician to be familiar with the management of HIV, including appropriate prescribing, ongoing monitoring, and ensuring patients remain linked with specialist services.
Practitioner’s Supply Order (PSO) for HIV post-exposure prophylaxis (PEP)
From 1 November 2026, emtricitabine with tenofovir and dolutegravir will be available on Practitioner’s Supply Order (PSO) for post-exposure prophylaxis (PEP) only. The availability of PEP through PSO is intended to support timely access to treatment following a potential exposure to HIV. Pharmac staff anticipate this pathway will primarily be used in urgent care settings, including Sexual Abuse Assessment and Treatment Services (SAATS).
The PSO must be endorsed for Post-Exposure Prophylaxis (PEP) only, supplied only by an authorised practitioner.
Supply of emtricitabine with tenofovir and dolutegravir via PSO for PEP is for an unapproved indication. It is the responsibility of the medical practitioner or authorised prescriber to obtain informed consent. See use of approved Medicines for an unapproved purpose | Medsafe
What is not changing
There is no change to the funded treatment options available for people living with HIV.
There is no change to current dispensing arrangements. Since 1 March 2026, antiretroviral medicines have been able to be dispensed STAT (3-monthly), allowing up to three months’ supply to be dispensed at one time. More frequent dispensing remains available where clinically appropriate to support adherence, monitoring, or individual patient needs.
These changes do not alter the standard of care for people living with HIV, or expectations regarding clinical management, monitoring, and ongoing specialist involvement.
For further information about these changes please see our webpage: Decision to remove the Special Authority and enable practitioners supply order (PSO) for some HIV medicines.
Please share this information
Please share this information with your colleagues and within your networks.
If you have any questions regarding these changes, please contact enquiry@pharmac.govt.nz.
Ngā mihi
Dr David Hughes
David Hughes
Chief Medical Officer | Director Advice & Assessment
________________________________________________________________________________
Pharmac | Te Pātaka Whaioranga | PO Box 10 254 | Level 9, 40 Mercer Street, Wellington
DDI: +64 21 962 317 | P: +64 4 460 4990 | www.pharmac.govt.nz