Children with life-threatening allergies whose families cannot afford to pay for EpiPen auto-injectors are at serious risk, say specialists.
Life-saving EpiPens - filled with adrenalin to treat anaphylactic shock - cost more than $150 each and expire after 12 months.
Dr Maia Brewerton, chair of the Clinical Immunology and Allergy Group, said there was huge hardship for families living with allergies, particularly the cost of the EpiPen.
"Food allergies can be fatal and all patients with a life-threatening food allergy should carry an EpiPen and have an anaphylaxis action plan.
"The lack of funded Epipens in New Zealand needs to be addressed."
Australia, which funds two EpiPens per patient per year, also has a national allergy strategy to ensure equitable services.
Such a national strategy was "urgently needed" in New Zealand, Dr Brewerton said.
"It is essential that health disparities seen amongst Māori and Pacific communities are addressed in the development of a National Allergy Strategy in New Zealand."
Pharmac's director of operations Lisa Williams said the agency did fund adrenaline in an ampoule that could be used with a needle and syringe by people experiencing anaphylaxis.
The ampoules cost about $1 each, compared with $150 for an EpiPen.
"Only the EpiPen brand of adrenaline auto injector is currently registered in New Zealand, which is why the supplier, Mylan, is able to set a high price," Ms Williams said.
Pharmac continued to talk with potential providers to reach agreement on price that would allow a registered adrenaline auto-injector to be funded - but it had to work within a fixed budget, she said.
"Pharmac must invest public money wisely.
"The flipside is considering funding an extremely expensive treatment that already exists in other forms, with the reality that it would take away funding from other more proven treatments."
Allergy New Zealand chief executive Mark Dixon said Pharmac was being "unrealistic".
"Pharmac has to meet the market rather than expecting the market to meet it.
"The chances of them finding a product that's priced closer to what they are willing to pay is unlikely to ever happen."
Pharmac's own advisory committee had recommended funding EpiPens - but families had been waiting 15 years so far - the longest of any medicine under consideration, he said.
"People who can't afford Epipens have to deal with snapping open glass vials of adrenalin, filling syringes and injecting themselves or their children deep into a muscle - a difficult ask in what's already a stressful situation."