Pharmac Consultation: Proposal to fully fund liquid nutrition replacements for adults with Crohn's disease requiring EEN

Pharmac is proposing to fully fund two liquid nutrition replacements for adults with Crohn’s disease who need to use them for an extended period as their only source of nutrition. This group of people had a fully funded option available to them, but the supplier stopped making it. The alternative is partly funded, and we want to remove this cost.

Learn more about the proposal to fully fund oral feed for adults with Crohn’s disease requiring exclusive enteral nutritionEnsure Plus and Fortisip, (200ml, 1.5kcal/ml) are the products we are considering in this proposal.

Society Member and New Zealand Registered Dietitian Catherine Wall has supplied the Society with the following main reasons to consider when making a decision in support of this proposal:

1. Clinical practice guidelines recommend EEN prior to surgery to manage Crohn's disease as it improves nutritional status, downgrades intestinal inflammation and is associated less surgical complications, shorter hospital length of stay and better patient quality of life.

2. Clinical practice guidelines suggest that EEN can be used as an alternative to corticosteroids and is special circumstances where corticosteroids are not recommended.

3. The cost for patients is one of main deterrents to more widespread use of EEN. Currently there is inequitable access with only patients with the financial means can afford to use EEN. The co-payment (of up to $2.50 per 200ml) excludes patients on benefits, low or middle incomes, students and people with high energy needs e.g. young adults who need to drink greater volumes.

4. The fully funded alternatives are either not evidence-based (e.g. fibre containing ensure powder) and are associated with side effects due to the resultant very high fibre intake or are low calorie, low protein and more expensive for Pharmac (e.g. Elemental 028).

If the decision is approved the change to funding would take effect from 1 July 2025.

The consultation is open now until 5:00PM 4 June. Tell Pharmac what you think about the proposal by emailing consult@pharmac.govt.nz

Pharmac’s website updated as the proposal progresses but if you have any queries regarding this proposal contact enquiry@pharmac.govt.nz