01 May 2024

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Pharmac has announced that currently no new patients can be started on funded dulaglutide (Trulicity) or liraglutide (Victoza). People with diabetes can still self-fund these medications, but unfortunately they are expensive. Empagliflozin (Jardiance or Jardiamet in combination with metformin) is usually the best alternative if no contraindications. People with diabetes already on dulaglutide and liraglutide can continue to have them prescribed, but many pharmacies are dispensing these medications weekly due to supply shortage. NZSSD is continuing to strongly advocate that the halt on prescribing for new patients is as short as possible due to the benefits for our high-risk whaanau with diabetes. We will keep you updated and always recommend best practice wherever possible.

18 April 2024

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The shortage of dulaglutide (Trulicity) and liraglutide (Victoza) continues to worsen and many scripts may not be able to be dispensed due to lack of stock, or dispensed weekly at best. Please check that your patients are receiving their medication and if not, to try other pharmacies or consider other alternative glucose lowering therapies if appropriate. Additional glucose lowering therapies may also be required for those prescribed multiple injections of Trulicity a week who are receiving one injection. Understandably, the shortage is causing significant distress for whaanau, pharmacies and prescribers, but unfortunately the shortage is likely to last for at least another year. Pharmac will likely be required to tighten the special authority further and we will keep you updated of any changes. It is more important than ever to ensure those with diabetes who need Trulicity or Victoza the most get treatment, and that Trulicity and Victoza are not being used for weight loss alone.

12 December 2023

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Pharmac have temporarily changed the special authority for GLP1 receptor agonists (GLP1RA; dulaglutide and liraglutide) because of the worldwide shortage of GLP1RA to the below:

• Patient has type 2 diabetes AND
• Target HbA1c of ≤ 53 mmol/mol has not been achieved despite the regular use of ALL the

following funded glucose lowering agents for a period of at least 6 months, where clinically, appropriate, empagliflozin, metformin and vildagliptin AND EITHER

• Māori and/or Pacific ethnicity OR
• Pre-existing cardiovascular disease or equivalent cardiovascular risk OR
• High lifetime cardiovascular risk due to being diagnosed with type 2 diabetes as a young adult OR
• Diabetic renal disease (UACR > 3 mg/mmol and/or eGFR < 60 mL/min)

Please note that the change was made without full clinical consultation and we understand that the new special authority criteria may lead to confusion. To maintain consistent supply of GLP1RA we recommend:

- Ensuring that GLP1RA are used only for glycaemic control and not for weight loss 

- To not switch between dulaglutide (Trulicity) and liraglutide (Victoza)

• The supply of both liraglutide and dulaglutide continues to be pharmacy and wholesaler dependent and we recommend checking with the patient’s pharmacy which GLP1RA is likely to be most reliably supplied and staying with that preparation.

We always recommend best practice and it is important that those who need GLP1RA the most receive GLP1RA, particularly those with type 2 diabetes and cardiovascular disease. For these patients, we do not recommend trialling and/or persisting with alternative glucose lowering therapies if clinically inappropriate and/or if ongoing adverse effects. But we all have a responsibility to be clinically judicious and we continue to work with PHARMAC on possible solutions such as dual funded empagliflozin with GLP1RA, funded GP visits and pharmacy education etc., but this is a work in progress and we continue to provide an update on this page.