What to do right now
a practical guide to submitting
The consultation closes 5pm, Thursday 28 May 2026. Less than 2 weeks. Here is exactly what you need to do.
I’ve spent the last four posts making the case. The Treaty argument. The evidence. The clinical logic. The ask to allies. If you’ve read this far, you don’t need more persuading. You need to know how to act.
So this one is practical.
What is this consultation?
Pharmac is proposing to change the Special Authority criteria for three funded diabetes medicines: empagliflozin (Jardiance), liraglutide, and dulaglutide (Trulicity). The proposed change would remove the ethnicity-based access pathway for Māori and Pacific peoples and replace it with a lower cardiovascular risk threshold.
The consultation is open to anyone. You do not need to be a clinician. You do not need to represent an organisation. You do not need to be Māori. You need to submit before the deadline.
Where do I submit?
Go to pharmac.govt.nz and find the current consultations page. The submission can be emailed or completed online. Copy the link: https://www.pharmac.govt.nz/news-and-resources/news/consultation-on-proposed-changes-to-diabetes-medicine-criteria
What should my submission say?
If you are writing as an individual, keep it simple. Three paragraphs is enough. Here is a structure that works:
Paragraph 1 — who you are and why you care. “I am a [GP / patient / health professional / community member] who [has worked with / lives in / cares about] Māori communities. I am writing to oppose the removal of the ethnicity criterion from the Special Authority for diabetes medicines.”
Paragraph 2 — the key argument. Pick the one that resonates most with you:
The criterion is working: Māori and Pacific access to these important medicines increased. Removing it risks reversing that.
A CVD risk threshold requires a completed risk assessment. Māori are less likely to have one, because of barriers to primary care access. Lowering the threshold will work for those with the best access - that doesn’t fix the problem — it relocates it.
The Treaty requires active protection of Māori health. This criterion is active protection. Removing it without an equivalent alternative is a Treaty breach.
Paragraph 3 — your ask. “I urge Pharmac to retain the ethnicity criterion in its current form, and to implement the lower cardiovascular risk threshold as an additional pathway — not a replacement.”
That’s it. Send it. Boom!
If you are writing as a clinician or organisation:
Consider adding:
Your clinical experience of how the criterion has changed your prescribing or your patients’ access
The Metcalfe et al. 2018 data (1.26 million missing scripts, 41% dispensing gap)
The Paul et al. 2023 NZMJ data on access post-criterion
A recommendation that Pharmac model universal HbA1c ≥53 access as an alternative - come on Pharmac, do better!
The deadline is 5pm Thursday 28 May 2026
I’ve been a GP in a Māori health practice long enough to know that the gains we make in this system are fragile, and that the people working hardest to dismantle them are often counting on us being too tired, too busy, or too disheartened to fight back.
I am tired. I am busy. I am not disheartened.
Because every week I see what these medicines do. I see the patient whose creatinine has stabilised. The tāne who came back for a follow-up, because something is working. The whānau member who will not need dialysis this decade because we got to her in time, because the criterion let us prescribe what she needed without making her jump through hoops she couldn’t clear.
That is worth fighting for. Thirty minutes of your time to write a submission is worth it.
Go to pharmac.govt.nz. https://www.pharmac.govt.nz/news-and-resources/news/consultation-on-proposed-changes-to-diabetes-medicine-criteria Submit before [date]. Share this with everyone you know who might.
Tēnā koutou katoa.
I make this submission from the Ōrākei clinic where I work, on the 25th of May 2026. This morning, people gathered just down the road at Takaparawhau — Bastion Point — to commemorate the 506 days of peaceful occupation that Ngāti Whātua ō Ōrākei undertook to resist the government of the day from taking the last few acres of their lands. Eventually the Crown apologised, stating that it "profoundly regrets and is deeply sorry for its actions" and that those actions "had devastating consequences for the . . . well-being of Ngāti Whātua Ōrākei." The settlement legislation records that the Crown "unreservedly apologises for not having honoured its obligations to Ngāti Whātua Ōrākei under the Treaty of Waitangi."
The Waitangi Tribunal's WAI 2575 inquiry found explicit Crown failures in Māori health access and called for active protection. History is repeating. Pharmac is complicit.
I make this submission from the Ōrākei clinic where I work, on the 25th of May 2026. This morning, people gathered just down the road at Takaparawhau — Bastion Point — to commemorate the 506 days of peaceful occupation that Ngāti Whātua ō Ōrākei undertook to resist the government of the day from taking the last few acres of their lands. Eventually the Crown apologised, stating that it "profoundly regrets and is deeply sorry for its actions" and that those actions "had devastating consequences for the . . . well-being of Ngāti Whātua Ōrākei." The settlement legislation records that the Crown "unreservedly apologises for not having honoured its obligations to Ngāti Whātua Ōrākei under the Treaty of Waitangi."
The Waitangi Tribunal's WAI 2575 inquiry found explicit Crown failures in Māori health access and called for active protection. History is repeating. Pharmac is complicit.