Most people may not know what is meant by PHARMAC and non-PHARMAC drugs.

To put simply, PHARMAC drugs are the ones which are funded by the New Zealand government under the public healthcare system and that have been approved by Medsafe. Some drugs are Medsafe approved but are not government funded. It is a common misconception that the public system pays for everything - treatment and medication - but this is not a 100 percent accurate assumption.

At the pharmacy, when you hand in your GP prescriptions, you get charged $5 for most medications. However, on some occasions you may also get told that certain medications are ‘full price’ and you pay that amount. Some cancer treatments are very expensive and can cost you more than $100,000. Are you prepared to be out of pocket by thousands of dollars should such a time come?

As the public system is currently under immense pressure to keep up, new cancer treatments continue to be a large area of PHARMAC’s expenditure. In the year to June 2017 total spend on cancer medicines was $203.8 million, or 17 percent of total spending on all medicines. The number of people receiving funded cancer medicines has risen by 50 percent while spending on cancer drugs has nearly doubled since 2011. More than a quarter of the spending was on two medicines alone – trastuzumab (Herceptin), and pembrolizumab (Keytruda).

This funding shortfall reflects the very high cost of new cancer treatments, and quite a few Kiwis find themselves seeking help from charitable foundations such as and it is unfortunate to be aware of these circumstances.

Having private health insurance gives you and your family the capability to tackle such unexpected life situations. Currently nib, one of New Zealand’s leading health insurers, provides cover for non-PHARMAC drugs for up to $300,000 under their Ultimate Health Max policy (and $600,000 if the treatment includes surgery). Unlike some insurance providers, nib’s Ultimate Health Max policy covers Medsafe approved non-PHARMAC drugs for many conditions, not just restricted to cancer alone.

If you already have health insurance cover in place, I suggest you speak to your adviser and find out if your current insurance policy covers you for non-PHARMAC drugs and treatment also. It is worth checking if that cover applies to just cancer or all medical conditions.

To get a comprehensive health insurance plan that covers you for all possibilities, talk to your adviser today!