In March 2009, PHARMAC widened access to oral isotretinoin for severe acne, granting prescribing rights to general practitioners. Formerly, only specialist dermatologists were entitled to prescribe isotretinoin, which was arguably due to the complexity of management and an appreciable risk of teratogenicity if given during pregnancy or within a month of conception. This funding restriction had the potential to create inequitable access barriers. These researchers report the outcomes of an audit on isotretinoin use in New Zealand by deprivation level and ethnicity, using dispensed prescription data for funded isotretinoin for the year ending June 2008. The researchers also analysed prescription data from the same period for cyproterone acetate with ethinyloestradiol, another acne pharmaceutical available on prescription with no funding restrictions. The data showed that people living in more deprived areas (as defined by NZDep Index) were less likely to use isotretinoin, as were Māori and Pacific people. The association with deprivation level was not present for cyproterone acetate with ethinyloestradiol, although disparities in use by ethnicity remained.
