11 December 2024
Yasir Shaik
[FYI request #29139 email]
Tēnā koe Yasir
Your request for official information, reference: HNZ00072084
Thank you for your email on 15 November 2024, asking Health New Zealand | Te Whatu Ora
(Health NZ) for the following under the Official Information Act 1982 (the Act):
The total amount of taxpayer money allocated for the procurement and distribution of
puberty blockers in New Zealand over the past five years. A breakdown of annual
expenditures on puberty blockers during this period."
Are puberty blockers administered or distributed within educational institutions, including
primary and secondary schools, as well as colleges? If so, please provide details on the
policies and protocols governing their administration in these settings.
What clinical guidelines does the Ministry of Health follow regarding the prescription and
administration of puberty blockers to minors?
What oversight mechanisms are in place to monitor the use of puberty blockers among
youth?
Response
For the sake of clarity, I wil address each question in turn.
The total amount of taxpayer money allocated for the procurement and distribution of
puberty blockers in New Zealand over the past five years. A breakdown of annual
expenditures on puberty blockers during this period.
Health NZ does not hold information on the total costs of procurement and distribution of puberty
blockers in New Zealand. However, the following table shows the total reimbursement cost to the
pharmacy for all publicly-funded dispensings of GnRHa (gonadotropin releasing hormone
analogue) goserelin and leuprorelin. The costs include for those under 25 years of age at the time
of dispensing.
Note that this data does not include the reason a medicine was prescribed (clinical indication).
Although one indication of these medicines is to block puberty, it may be prescribed for other
reasons such as precocious puberty and endometriosis, among others.
Total cost by calendar year
Chemical
2019
2020
2021
2022
2023
Goserelin
$24,767.58
$41,516.43
$45,817.83
$46,890.95
$48,586.25
Leuprorelin
$222,657.18
$235,630.25
$312,378.23
$260,274.13
$216,975.48
Please note that this data is provisional and used for operational purposes. It has not been through
the full quality assurance process that we use before publishing data and is therefore subject to
change.
Are puberty blockers administered or distributed within educational institutions, including
primary and secondary schools, as well as colleges?
Puberty blockers are not administered or distributed; they are prescribed for a named individual.
Puberty blockers are prescribed by experienced clinicians in the context of an interdisciplinary
team approach. Prescription of these medicines occurs in health service settings. Some
educational institutions such as universities may have on-site health clinics as part of the services
they offer their students. Treatment decisions for those aged less than 18 years are made
collaboratively by health professionals, patients, and (as appropriate) their families, through
a patient and family-centred process involving informed consent.
If so, please provide details on the policies and protocols governing their administration in
these settings.
Puberty blockers are not administered, they are prescribed. As with other medicines, prescriptions
for puberty blockers are dispensed at pharmacies. Prescribing clinicians are required to follow
clinical best practice guidance on the provision of all medications, including puberty blockers, and
are expected to keep up to date with clinical best practice.
What clinical guidelines does the Ministry of Health follow regarding the prescription and
administration of puberty blockers to minors?
The Ministry of Health published an evidence brief and position statement on the provision of
puberty blockers in the context of gender-affirming care in November 2024. The Ministry of
Health’s position states that clinicians initiating puberty blockers should be experienced in
providing gender-affirming care and be part of an interprofessional team offering a full range of
supports to young people presenting with gender-related issues. You can find the Ministry’s
position statement here:
www.health.govt.nz/system/files/2024-
11/Position_Statement_on_the_Use_of_Puberty_Blockers.pdf
In addition to existing clinical pathways that provide guidance on access to services locally and
regionally, Health NZ is also developing an updated guideline to support clinicians providing
gender-affirming care, including the provision of puberty blockers. The clinical guidelines for
gender-affirming care currently available in New Zealand include:
• Guidelines for gender affirming healthcare for gender diverse and transgender children, young
people and adults in Aotearoa, New Zealand:
https:/ researchcommons.waikato.ac.nz/entities/publication/e0aca807-f3f4-4fc3-bf28-
4754d8ab4c38
• Primary Care Gender Affirming Hormone Therapy Initiation guidelines:
https:/ blogs.otago.ac.nz/rainbow/files/2023/03/Primary-Care-GAHT-Guidelines_Web_29-
Mar.pdf.
What oversight mechanisms are in place to monitor the use of puberty blockers among
youth?
In New Zealand, the Ministry of Health and other regulatory bodies oversee the practice of health
professionals. Medsafe is the New Zealand Medicines and Medical Devices Safety Authority
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responsible for monitoring the safety of all medicines that have been approved for use in
New Zealand. More information about the mechanisms it uses can be found on its website:
www.medsafe.govt.nz/Consumers/Safety-of-Medicines/Medicines-Safety-and-
Pharmacovigilance.asp.
How to get in touch
If you have any questions, you can contact us at
[email address].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may proactively
release a copy of this response on our website. Al requester data, including your name and
contact details, wil be removed prior to release.
Nāku iti noa, nā
Deborah Woodley
Director Starting Wel
Planning, Funding & Outcomes
TeWhatuOra.govt.nz
Health NZ, PO Box 793,
Wel ington 6140, New Zealand
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