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Agency for Care Effectiveness
Drug guidance

Selexipag for treating pulmonary arterial hypertension

5 October 2026

Condition

Cardiovascular

Published on 13 Sep 2024
Last Updated on 05 Oct 2026

Guidance Recommendations

The Ministry of Health’s Drug Advisory Committee has recommended:

  • Selexipag 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1,000 mcg, 1,200 mcg, 1,400 mcg and 1,600 mcg tablet, to be added as the second or third drug in a combination treatment for pulmonary arterial hypertension, in line with the following criteria:

    • Patient is already receiving an endothelin receptor antagonist and/or a phosphodiesterase type 5 inhibitor at maximum tolerated doses; and

    • Prior to adding selexipag treatment, patient is assessed to have intermediate to high risk of 1-year mortality (according to the European Society of Cardiology/European Respiratory Society risk-stratification tool) during follow-up.

Funding status

Selexipag 200 mcg, 400 mcg, 600 mcg and 800 mcg tablets are recommended for inclusion on the Medication Assistance Fund (MAF) for the abovementioned indication from 1 November 2025.

Selexipag 1,000 mcg, 1,200 mcg, 1,400 mcg and 1,600 mcg tablets are recommended for inclusion on the MAF for the abovementioned indication from 1 December 2026.

Selexipag for treating pulmonary arterial hypertension (Published 05 Oct 2026) [PDF, 185.18 KB] (opens in new tab)

Plain English Summary

Pulmonary arterial hypertension is a progressive condition in which the blood vessels that carry blood from the heart to the lungs become narrowed. This causes high blood pressure in the lungs and makes the heart work harder. Over time, it can lead to right-sided heart failure. Symptoms include fatigue, shortness of breath, fainting spells, chest pain and a rapid heart rate.

Selexipag belongs to a group of medicines called prostacyclin receptor agonists. It helps widen the blood vessels in the lungs and lower blood pressure. It is taken orally in addition to other treatments when pulmonary arterial hypertension is not adequately controlled.

Selexipag was recommended for government subsidy because its benefit justifies its cost. It is included in the Medication Assistance Fund (MAF) (opens in new tab), with its cost subsidised by 40% to 75% for eligible patients.