💊 Pharmac扩大高胆固醇药物Rosuvastatin使用范围（新西兰医保改革）
新西兰药品管理机构 Pharmac 宣布，将从2026年10月1日起全面放宽 Rosuvastatin（瑞舒伐他汀）使用资格，使更多人可以在医生评估后获得该药物治疗高胆固醇。
该政策由副卫生部长 David Seymour支持公布。
📌 关键变化
✔️ 取消所有资格限制
未来Rosuvastatin的使用将：
- ❌ 不再限制族裔（包括此前的 Māori / Pacific 优先条件）
- ❌ 不再设定复杂资格门槛
- ✔️ 完全基于临床医生判断（clinical need）
只要医生认为患者需要，就可以开具处方。
🧠 药物作用
Rosuvastatin是一种他汀类药物，用于：
- 降低胆固醇
- 减少心脏病发作风险
- 降低中风风险
- 改善心血管疾病长期风险管理
📈 预计影响人数
Pharmac估算：
- 目前约 7.6万人/年使用
- 新规后：
- 第一阶段新增约 8.1万人
- 5年内新增约 10.8万人
👉 药物覆盖人群将明显扩大
🏥 对现有患者影响
- 已使用该药的人 不会受到影响
- 现有治疗方案保持不变
💰 资金来源
Pharmac表示：
- 政策通过2025/26年度“Annual Tender”节省资金实现
- 该机制每年可释放约：
- 3000万至5000万纽币
- 用于支持新药或扩大药物覆盖
⚖️ 政策背景与争议点
✔️ 政府立场
Seymour表示：
- 医疗资源应基于“临床需要”
- 减少心血管疾病住院率
- 提高系统效率与健康结果
📊 现有资格（取消前）包括：
目前Rosuvastatin限制较多，例如：
- Māori / Pacific高风险人群优先
- 10年心血管风险 ≥15%患者
- 已确诊心血管疾病患者（需满足胆固醇标准）
- 遗传性高胆固醇患者
👉 新政将这些“分类标准”全部移除
Associate Health Minister David Seymour welcomes Pharmac’s proposal to widen access to Rosuvastatin based on clinical need.
“Improving access to medicines in New Zealand is important to patients and their families. That’s why it has been a focus for this Government,” Mr Seymour says.
Pharmac will widen access to Rosuvastatin from 1 October 2026 by removing all eligibility criteria, including ethnicity criteria. It will remain a prescription only medicine, so clinicians will decide who needs it.
“Rosuvastatin lowers cholesterol and reduces the risk of heart attacks and strokes in people with high cholesterol. Clinicians are best placed to determine who needs Rosuvastatin. If a clinician thinks a patient would benefit from this medicine, they should be able to prescribe it to them, regardless of their ethnicity,” Mr Seymour says.
“Supporting earlier and more effective management of high cholesterol for everyone will reduce avoidable hospital admissions and improve health outcomes.
“Around 76,000 New Zealanders currently use rosuvastatin each year. We estimate that once we change the eligibility criteria about 81,000 more people would access it in the first year, growing to about 108,000 more people over five years. People already receiving these medicines will not be affected by the proposed changes.
“Pharmac can afford to pay for this through their 2025/26 Annual Tender. The annual tender helps Pharmac manage how much New Zealand spends on medicines by reducing the cost of those we already fund. Annual tender changes allow Pharmac to free up between $30 million and $50 million to spend on new medicines annually.
“Pharmac heard through previous funding decisions, consultations, and engagement with health professionals and consumers that there is strong support for today’s decision. Because Pharmac already knew there is strong support for this decision, they didn’t want to waste time on further consultation. It’s great to see Pharmac move swiftly with this decision. The sooner people can access this medicine, the better.
“We’re making the system work better for the people it serves. When people can access their medicines easily, they stay healthier for longer. It also reduces pressure on other parts of the health system.”
A person is currently eligible for treatment with Rosuvastatin:
if they are considered at risk of cardiovascular disease and are Māori or Pacific; or
if they have a 15% or higher chance of having a heart attack over the next five years, and their cholesterol is above a certain level after trying other funded statin medications; or
if they have established cardiovascular disease, and their cholesterol is above a certain level after trying other funded statin medications; or
if they have a genetic disease that causes them to have high cholesterol, and their cholesterol is above a certain level after trying other funded statin medications.
