A false economy?

Press release

Budget 2024 ignores over 753,000 people affected by one of Aotearoa New Zealand’s most disabling conditions

The number of people estimated to be affected by migraine disease in Aotearoa New Zealand has risen from 642,000 to 753,000. Migraine ranks in the top four conditions in Aotearoa New Zealand for the highest number of years a person lives with impaired function. Despite this data and government rhetoric about addressing the country’s productivity problem, Budget 2024 has left people with migraine disease without hope as the first medications developed specifically to prevent migraine disease remain unfunded. The cheapest of these targeted medications available in the country, which are calcitonin gene-related peptide (CGRP) monoclonal antibodies, costs an average of $325 per injection and needs to be repeated every four weeks after a loading dose of two injections.

It’s estimated only 16.6% of people with migraine in NZ face no work-related difficulties because of the disease, which begs the question – how much is not funding these preventive treatments really costing us? Dollar values aside, people living with migraine disease have higher rates of depression and anxiety and we’re losing some top talent through our medicine access crisis as some of our most skilled workers become “medical refugees.”

Migraine Foundation Aotearoa New Zealand co-founders Sarah Cahill, Suzanne Vale and Dr Fiona Imlach are dismayed by the budget’s omission of people struggling with the disease around the country. They note that migraine has been chronically under researched worldwide, even more so in the context of our own population, and subsequently treatment is underfunded. With the status quo set to remain following the budget unveiling, Dr Imlach highlights the juxtaposition of journalist and health advocate Rachel Smalley being awarded a New Zealand Order of Merit in the King’s Birthday Honours list.

Recommendations for granting the honours to nominees are made to The King by the Prime Minister, yet Christopher Luxon has made no public attempts since taking office to reform or reproach the behaviour of government medicine buying agency Pharmac, as CEO Sarah Fitt’s contempt towards Smalley was made public late last year, alongside other staff members’ unprofessional and offensive behaviour.

Dr Imlach says, “We’d like to recognise the incredibly important work Rachel has done with The Medicine Gap, and whilst we at the Foundation are thrilled that her achievements have been honoured, it throws into sharp relief the fact Smalley and all health advocates are battling some pretty major and fundamental issues with an agency that is answerable to our government.”

The Medicine Gap advocates for a “modern, cost-benefit analysis for medicines and medical devices which looks at the ‘value’ of a medicine, and considers the financial, economic, and social impact of untreated disease on our society.” It also notes that we are placed at the bottom of the developed world for access to modern medicines.

Vale adds in the wake of the disappointment many are feeling about the government’s failure to fulfil its promise to fund cancer drugs, “When a party has to campaign on a political promise such as funding life-saving medications, it reveals that the model of the agency whose job it is to secure these treatments for New Zealanders is broken.”

Migraine Foundation Aotearoa New Zealand submitted an application in November 2022 to Pharmac to consider adding the migraine-specific medication Emgality to its Options for Investment list. Since then, the Foundation has corresponded and met with Pharmac and tirelessly advocated for funding of Emgality and two other migraine medications (Aimovig and Qulipta). This process has progressed one step further as of last week, with all three medications being allocated to Pharmac’s Options for Investment list for treatment of both episodic and chronic migraine.

Cahill comments on this achievement that, “While this is a great milestone, and one the migraine community can be proud of, it doesn’t mean that these will be funded, at least anytime soon. The Options for Investment list is Pharmac’s list of medications it would fund, if it had the budget to do so. Unfortunately, Pharmac’s budget is woefully inadequate and David Seymour’s announcement of additional Pharmac funding at the Medicine Access Summit in April 2024 won’t be enough to cover new medicines, that is, the ones on Pharmac’s Options for Investment list, but will only keep existing medicines on the books. It takes on average seven to eight years for a new medicine to get funded in New Zealand, from application to funding, and over 2 years from getting on the priority list to funding. This will get worse with many more new medicines in the pipeline and no plans for additional government funding.”

Migraine Foundation Aotearoa New Zealand will continue to advocate for people with migraine in New Zealand, including putting pressure on the government and Pharmac, and educating communities and GPs about the disease.