Cost of Bremelanotide in New Zealand
Bremelanotide (Vyleesi) is not currently funded or available in New Zealand's pharmaceutical schedule, so patients would need to pay the full cost out-of-pocket, which is likely to be prohibitively expensive.
Medication Information
Bremelanotide is an FDA-approved medication for premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD). It works as a melanocortin receptor agonist and is administered as a subcutaneous injection.
Key Facts:
- Administration: Self-administered subcutaneous injection in the abdomen or thigh at least 45 minutes before sexual activity 1
- Recommended dose: 1.75 mg per injection 1
- Maximum usage: No more than 1 dose in 24 hours and no more than 8 doses per month 2
Cost Information
While specific New Zealand pricing is not available in the provided evidence, we can make some inferences based on US pricing data:
- In the US market, medications for sexual dysfunction tend to be expensive and often not covered by insurance
- Based on US pharmaceutical pricing patterns for specialty medications, the monthly cost would likely be several hundred to over a thousand NZD
- The medication requires a prescription and would need to be imported as a "special authority" medication since it's not on the New Zealand Pharmaceutical Schedule
Efficacy and Clinical Considerations
When considering the cost-benefit ratio, it's important to note:
- Clinical trials showed statistically significant but modest improvements in desire and reduction in distress related to low sexual desire compared to placebo 3, 4
- In phase 3 studies, bremelanotide demonstrated improvements in desire, arousal, and orgasm scores compared to placebo 5
- The NCCN guidelines note that bremelanotide "may be an appropriate option for some survivors with HSDD" 3
Side Effects and Safety Considerations
Common side effects include:
- Nausea (40% vs 1.3% for placebo) - most common reason for discontinuation 5
- Flushing (20.3% vs 1.3%) 5
- Headache (11.3% vs 1.9%) 5
- Injection site reactions (5.4% vs 0.5%) 5
Small and transient but statistically significant blood pressure increases were observed during monitoring, suggesting caution in patients with cardiovascular risk factors 5.
Alternative Options
Given the likely high cost and limited availability in New Zealand, patients might consider:
- Flibanserin (if available)
- Off-label options like bupropion or buspirone 3
- Non-pharmacological approaches including psychological counseling and sex therapy
Accessing the Medication in New Zealand
If a patient is determined to obtain bremelanotide in New Zealand:
- Consult with a healthcare provider for a prescription
- Work with a pharmacy that can arrange special importation
- Be prepared for significant out-of-pocket costs
- Consider whether the modest clinical benefits justify the expense
The medication should be discontinued after 8 weeks if no benefit is observed 2.