Parkinson's medicines in New Zealand — what Pharmac funds and what the $5 charge really costs

Parkinson’s medication is not a course of treatment. It is a standing order that runs for the rest of your life, and it usually grows — one tablet three times a day becomes four medicines at five different times. So the question is not what a box costs once. It is what the whole arrangement costs every year, and which parts of it the state has already paid for.

New Zealand splits this into two systems that people constantly merge into one:

• Pharmac decides which medicines are funded, and on what terms. That decision is about the medicine.
• The prescription charge is a flat co-payment you pay the pharmacy per item. That charge is about you, not about the medicine.

You can be prescribed a fully funded medicine and still pay at the counter. You can also pay nothing at all for the same medicine, depending on your age and your card. Both facts are below, checked in August 2026.

What Pharmac funds for Parkinson’s

The Pharmaceutical Schedule groups these under Agents for Parkinsonism and Related Disorders. As at the August 2026 Schedule, the funded list is:

Apomorphine is worth a separate note because it is the one people assume will be a fight. It is funded, under the brand Movapo, as an injection — $59.50 subsidy for the 10 mg per ml, 2 ml ampoule and $121.84 for the 5 ml ampoule at the August 2026 Schedule. The Schedule also records that “Three months supply may be dispensed at one time if endorsed ‘certified exemption’ by the prescriber or pharmacist.”

Rasagiline arrived through a Pharmac consultation in April 2021, which was explicit about access:

No eligibility criteria have been proposed for rasagiline and it would be funded for all New Zealanders who need it.

What is not on the Schedule

This is the more useful half of the list, because it explains conversations that otherwise make no sense — a specialist mentioning a patch, a relative overseas describing a medicine you cannot get.

As at the August 2026 Schedule, the following do not appear as funded community medicines in New Zealand: rotigotine (the transdermal patch), selegiline, opicapone, safinamide and istradefylline.

That does not mean they do not exist here or that nothing can be done. It means they are not subsidised through the community Schedule, so getting one involves either paying privately, where the medicine is available at all, or the exceptional-circumstances route below.

Pharmac’s route for this is called Named Patient Pharmaceutical Assessment (NPPA) — its official name, worth keeping exactly as written so you can find it. Pharmac uses the process to decide whether to fund a treatment for one named individual whose clinical circumstances are exceptional.

Three things about it are worth knowing before you raise it.

• You cannot apply. “Only authorised prescribers can submit NPPA applications, within their scope of practice.” Other health professionals can prepare the paperwork, “but a prescriber must be named as the applicant.”
• Funded alternatives come first. Pharmac requires that all suitable funded options have been tried, and says treatments funded this way “must be ‘end of spectrum’. This means that there are no other clinically suitable funded options for the person.”
• It is not a second queue. In Pharmac’s words, “NPPA cannot be used to undermine the Pharmaceutical Schedule by providing a competing pathway to access funded treatment.” If Pharmac has already considered the medicine for that use, it is unlikely to fund it this way without something exceptional about the individual situation.

Prescribers who want to talk it through before applying can ring Pharmac on 0800 660 050 (option 2).

Special Authority: it is the non-motor medicines, not the Parkinson’s ones

Pharmac’s line is that it “sets specific criteria that must be met before some medicines will be funded.” Applications go through the Electronic Special Authority system, and — the part people get wrong — your prescriber applies, not you. There is nothing for you to post.

Where this actually shows up in Parkinson’s is in the medicines used for the symptoms that are not tremor and stiffness. Several of these are Special Authority items in the August 2026 Schedule:

Being on that list does not tell you whether you personally meet the criteria — that is the point of criteria. What it tells you is that a “no” at the pharmacy counter is not the end of the road, and that the next step is a conversation with the prescriber about an application, not a complaint to the pharmacy. Pharmac’s own email for questions about criteria is enquiry@pharmac.govt.nz; problems with a submitted application go to 0800 855 066.

The $5 charge, and the 20-item ceiling

Health New Zealand’s rule is plain:

People need to pay the standard $5 prescription charge, with exemptions for people: aged 13 years or under; holding a Community Services Card (CSC), or a dependent child of a CSC holder; aged 65 years or over; holding a Prescription Subsidy Card (PSC).

Two of those exemptions cover a large share of people living with Parkinson’s, and they are worth saying out loud because people assume they still owe the money.

If you are 65 or over, there is no prescription charge. If you hold a Community Services Card, there is no prescription charge — and Supported Living Payment brings a Community Services Card with it automatically. If you do not have one, see Community Services Card and High Use Health Card.

For everyone else, the charge is $5 per item, and then the ceiling arrives:

You become eligible for the subsidy once you have paid for 20 prescription items from 1 February each year. Once you are eligible, you do not have to pay any more prescription charges for the rest of that year (to 31 January).

The counting is done from electronic records, and it is a household count, not a personal one:

You can reach the 20-item threshold by combining prescription items for your partner and dependent tamariki aged from 14 up to 18.

And to claim it:

Talk to your pharmacist and make sure they know the names and ages of all the people in your whānau. Your pharmacist will check the electronic records to see how many prescriptions you and any eligible whānau members have paid for since 1 February. If the total is 20 or more, you will qualify for a prescription subsidy. Any pharmacy can check your eligibility.

Note the reset date. The year runs 1 February to 31 January, not the calendar year and not the tax year. Your count goes back to zero on 1 February, which is why a February pharmacy bill can be a surprise after months of paying nothing.

Three practical things that change the bill

If a medicine is not fully subsidised there can be more to pay on top, and that part is not affected by any of the above: “Fees for medicines that are not fully funded by Pharmac remain the same.” Ask the pharmacy what the extra is before the prescription is dispensed, not after.

Where to check, before you believe anything

Funding decisions change month by month, and the Schedule is republished monthly. Anything on this page is a snapshot of the August 2026 Schedule.

If this applies to you

This page is not medical advice and does not tell you what to take or change. Funded status is from the Pharmaceutical Schedule of August 2026 and the Schedule is updated monthly. Check the current Schedule and talk to your care team and pharmacist about your own medicines.