Health NZ has confirmed in writing that it funds intermittent high-flow oxygen for the acute treatment of cluster headache under Community Oxygen Therapy Services. It has also clarified that a blood gas test is generally not required to start short-burst high-flow oxygen, that a neurology referral is not required for acute oxygen treatment, and that ongoing home oxygen is a respiratory-service referral once the diagnosis is confirmed.
What Health NZ confirmed first
On 27 July 2026, Health NZ responded to a CHNZ Official Information Act request about oxygen funding for cluster headache. The key answer was direct: Health NZ said it funds intermittent high-flow oxygen for this purpose under Community Oxygen Therapy Services, administered through Community Services for people in their homes.
Health NZ also confirmed that this oxygen access does not sit with PHARMAC. PHARMAC separately told CHNZ the same thing. In plain terms, the funding route is Health NZ and district community oxygen services, not a medicine subsidy route.
What Health NZ clarified in August
CHNZ asked Health NZ to clarify the parts that were still hard for patients and GPs to use. In its 25 August 2026 response, Health NZ confirmed three practical points.
- For short-burst high-flow oxygen, an arterial blood gas assessment is generally not required; those thresholds relate to long-term oxygen therapy.
- A neurology referral is not required before acute oxygen treatment. A GP can prescribe and administer oxygen for an acute attack in clinic.
- For ongoing home oxygen, the referral is to the district respiratory service once the diagnosis is confirmed. Health NZ also confirmed cylinder oxygen, not a concentrator, for this indication.
What is still not fixed
The national service specification still does not clearly name cluster headache in the adult appendix. Health NZ has said it will fix the broken TSANZ link and name cluster headache when the specification is reviewed, but it has not given a date.
One sentence in the specification also remains a problem because it refers to intermittent oxygen as placebo in a way that is easy to misread. Health NZ has said that sentence is about chronic hypoxaemia, not cluster headache. That distinction matters, but it would be safer if the document said so clearly.
What to show a GP or respiratory service
If you are told oxygen for cluster headache is not funded in New Zealand, the best starting point is the Health NZ OIA correspondence PDF and the GP factsheet on this website. Those documents show the funding answer, the referral clarification and the cylinder/concentrator distinction.
If a service still says no, ask for the reason in writing. The reason matters. A safety concern, an uncertain diagnosis, no local pathway, an equipment problem and a funding misunderstanding are different problems. They need different solutions.
About reporting and data
The Community Oxygen Therapy Services specification includes monthly reporting to the National Non-Admitted Patient Collection for community oxygen activity. CHNZ is still seeking better visibility of how many people are receiving funded oxygen for cluster headache and whether access differs by district.
We are not currently saying there is a confirmed national requirement to report every individual decline for cluster headache oxygen. What we can say is more careful: decisions should be recorded, reasons should be visible to the referrer and patient, and operational barriers should not be hidden as if they were clinical refusals.
Where CHNZ goes next
The practical work now is to make the pathway easy for clinicians to use. That means a clear HealthPathways entry, a corrected national service specification, local respiratory service contacts, a realistic cylinder/refill process, and a way to resolve declined or delayed access without leaving patients to start again from zero.