How to get the NZ Govt to fund your Sativex
So you’ve just been approved for Sativex, great! welcome to an exclusive club.
Unfortunately unless you are in the top 5% of NZ incomes, the cost of Sativex is impossibly hard to stomach. 3 Bottles are frequently quoted as costing approx $1300, this is with the pharmacies taking a large markup, so be sure to grease up to your friendly pharmacist in the hope of a reduced markup, the lowest MCaNZ has heard is that it can cost $990 from a sympathetic pharmacy.
Currently, we are aware of 4 methods of obtaining funding for Sativex, 3 of which we aware have worked, they are;
- ACC funding
- WINZ Temporary Additional Support
- WINZ Special Benefit
- NPPA; (no success so far)
ACC Funding,
It is possible to have ACC fund Sativex, MCaNZ is currently aware of 2 people who have had ACC pay for their Sativex off label for chronic pain, one has Complex Regional Pain Syndrome, the other had several nerve roots damaged in a botched spine operation. As an off label use for pain, ACC will decline it by default. The key to win over ACC for unapproved or off label use is to pay for it yourself for 3 months, and if it works very well, take ACC to review. In review, moving stories from the claimant and families of the improvement in quality of life should overrule the defensive arguments that ACCs (likely expensive) Lawyer will try and dish up regarding lack of evidence etc. Personal use with improvements is all the evidence a court needs to outweigh theoretical arguments of no benefit and or lack of evidence, the patient is the evidence.
WINZ Temporary Additional Support
It is possible to have WINZ pay for Sativex for up to 12 weeks, at a funding level of 80% for the medicine, this has been done for a patient in Northland and although not complete funding, this