Why some New Zealanders are stuck on monthly eye injections, and the case for funding Eylea HD?
The current Pharmac Special Authority criteria for anti-VEGF treatment of neovascular age-related macular degeneration and diabetic macular oedema leave two groups of patients without a longer-acting alternative.
The first is patients established on Eylea (aflibercept 2 mg) for more than three months prior to Vabysmo (faricimab) becoming funded; under the current criteria, this prior treatment is an explicit exclusion from switching to Vabysmo, leaving these patients on monthly injections indefinitely.
The second is the minority of patients who, in the pivotal trials, do not respond well to Vabysmo and cannot be extended beyond eight-weekly dosing. For both groups, a longer-acting agent is clinically necessary but currently not available in New Zealand.
Eylea HD (aflibercept 8 mg) is the obvious candidate. The phase 3 PULSAR and PHOTON trials show non-inferior visual acuity to standard-dose Eylea, with longer dosing intervals, fewer injections per year, and superior fluid resolution in the retina.
On 28 April 2026 I submitted a formal Pharmac funding application for Eylea HD, with revised Special Authority criteria designed to close this gap. The submission is endorsed by Macular Degeneration New Zealand, Ophthalmology New Zealand, Eye Health Aotearoa, and the New Zealand Save Sight Society — together we are calling on Pharmac to act for the patients who have been left behind.
I am sharing the documents here so that patients, their families, and the wider clinical community can see exactly what is being proposed, and what change we are pushing for.
A Pharmac funding submission for aflibercept 8 mg (Eylea HD)
