If you’ve been following my journey since THE MISSING PIECE was released in January 2024, you’ll know how stressful it’s been for New Zealand adults seeking an ADHD diagnosis and accessing stimulant medication. Here’s a clear update on what’s changed:
No More Two‑Year Psychiatrist Reassessments (from 1 December 2024)
Until late 2024, anyone taking funded ADHD stimulants such as methylphenidate or dexamfetamine needed a psychiatrist reassessment every two years to renew their Special Authority Number. This led to long specialist wait lists, expensive private assessments and ongoing stress.
From 1 December 2024, Pharmac removed this renewal requirement. Once the initial Special Authority is granted, a GP or nurse practitioner can continue prescribing without another specialist referral.
More Funded Stimulant Options (from 1 December 2024)
At the same time, Pharmac began funding lisdexamfetamine (Vyvanse) as an additional stimulant treatment. This decision was in part to ease supply pressures on methylphenidate, which has experienced ongoing shortages since September 2023.
GP & Nurse Practitioner Role in Diagnosis and Prescribing (from 1 February 2026)
A major milestone is the ability for general practitioners and nurse practitioners to diagnose and begin treatment for adult ADHD. From 1 February 2026, they will be authorised to prescribe stimulant medications, including methylphenidate, dexamfetamine and lisdexamfetamine, without needing a psychiatrist’s prescription.
What Still Needs Determining
- Training and consistency: GPs and nurse practitioners will require significant upskilling before they begin assessing and prescribing ADHD medication. Not all will be ready simultaneously. We will watch this space to hear how this will roll out.
- Meeting costs: Given ‘normal’ GP visits are based on 10-15 minutes per patient, ADHD assessments may require at least 60 minutes. This will naturally impact on patient fees and potentially impact GP availability.
What This Means for THE MISSING PIECE Readers
These changes represent real progress:
- The removal of two‑year psychiatrist reassessments now reduces major barriers to ongoing medication (cost and delays).
- Funding of lisdexamfetamine gives adults a new once-a-day stimulant option.
- Empowering GPs and nurse practitioners to diagnose and prescribe for allows faster, more local access to adult ADHD care.
This is not perfection, but it is meaningful improvement in access, convenience and treatment choice.