After 27 years of operating without review, Pharmac has been told that its days as “the independent republic of Pharmac” are over, writes Anna Rawhiti-Connell in The Bulletin.
Health minister Andrew Little releases Pharmac review
Commenting on the review, Little said Pharmac “needs to be working appropriately with the rest of the health administration”. The review made 33 recommendations and the government has accepted most of them. The review found the agency’s performance needed to “substantially improve” and that its approach had “in all likelihood” contributed to Māori and Pacific people receiving a lower share of new medicines funded over the last decade. Lung cancer drug funding is often cited as an example of inequity. Its incidence and mortality rates are four times higher for Māori and Pacific people but New Zealand has lagged behind countries like Australia and Japan in funding lung cancer drugs.
Pharmac accepts the findings
In response to the review, health and patient advocates say radical action is needed urgently to tackle the delays patients face in getting the latest drugs. According to RNZ, Pharmac declined to be interviewed about the review but sent a statement. “There are important improvements for us to make and we look forward to working with other health agencies on implementing the recommendations supported by the government” the statement said. Little said Pharmac could adapt over the two years it would take for the health reforms to bed in. The review acknowledged that the Pharmac team were skilled, and recognised the difficult commercial environment it was operating in. The review panel was chaired by former Consumer NZ head, Sue Chetwin.
27 years too long to wait for a review
The review was a 2020 election promise from Labour and the government has been criticised for several delays in completing and releasing it, the first of its kind since the agency was set-up. The review summary notes that 27 years is too long to wait for a first review. That lag probably reflects a lack of public visibility. Most of us don’t connect a trip to the chemist for subsidised antibiotics with the agency. As many submitters told the review panel, interacting with Pharmac and its decision-making becomes all too real when you’re dealing with a debilitating or life-threatening illness.
Demands for greater transparency heard
Over recent years, patients, health professionals and advocacy bodies have become more vocal about unfunded treatments for cancer and rare disorders and delays between recommendations and funding. As Kathy Spencer writes for NZ Herald (paywalled) a particular treatment for breast cancer was first recommended by Pharmac’s advisory committee in 2014 but wasn’t funded until 2019. RNZ’s Guyon Espiner undertook a four-part investigation into Pharmac in 2019 uncovering a kind of Dallas buyers club for unfunded lung cancer medication and third world diabetes treatment. His second story for the series was about Pharmac’s “secret list” which left patients in the dark about when medicine might be funded. One of the review’s key recommendations was that greater transparency was required from Pharmac over processes, decision-making and the provision of information for the public.
