Medsafe is responsible for regulating medicines and medical devices in New Zealand. The 20 District Health Boards (DHBs) have a budget for medicines which PHARMAC (the medicines procurement agency) manages. PHARMAC’s Pharmacology and Therapeutics Advisory Committee (PTAC) reviews funding applications for cost-effective new medicines and PTAC makes recommendations on which medicines should be publicly funded by PHARMAC. Until these cost-effective medicines are funded, they remain on a Waiting List.
Unnecessary delays in the funding system provide significant setbacks for the health system and patients who could benefit from the medicine being funded. Some patients are still waiting a decade or longer for a public funding decision on some of these medicines.
While comparable countries have access to breakthrough world-class medicines and treatments, our current funding model continues to deprive New Zealanders of publicly funded access to these medicines. In many cases, modern medicines that are recommended as a priority by PTAC to be publicly funded remain unfunded despite PTAC’s clinical expertise.1
Currently, the medicines budget setting process is complex and not clear.
The allocation of the total funds granted by parliament for health services are negotiated between New Zealand’s twenty DHBs and the Medicines Procurement Agency and then sent to the Minister of Health for budget approval. In theory, the decision sits with the DHBs but, in reality, it is the Minister who decides whether to top up the medicines budget over what may have been initially agreed.2
The medicines waiting list is made up of over 100 prioritised medicines that have been registered in New Zealand and recommended by PTAC but await public funding.
The existence of this waiting list (of more than 100 recommended medicines) is evidence that New Zealand’s medicines funding processes and budget levels require review. Without a review, the waiting list is likely to remain – and possibly grow.1
New Zealand’s failure to fund proven modern medicines lets down many New Zealand patients who rely on the public health system to be there when they need it.
The failure to fund cost-effective medicines results in higher hospitalisation and mortality rates.8-11
Other countries have better access to modern medicines which, in many cases, can be linked to better outcomes in those countries.8-11
Due to the lack of funding for so many modern medicines, many patients are forced to try and fund them themselves.
Because unsubsidised modern medicines are often unaffordable for the average Kiwi, these patients are forced to take extreme measures to get the medicine they need, including;
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Including patients, clinicians, industry and other stakeholders affected by medicines funding decisions in the consultation process allows for an inclusive and holistic decision to be made.
Additionally, making the allocation of the medicines budget transparent means that funding can be easily and accurately measured.
Transparency in the budget setting process would mean Parliament would decide on the overall national medicines budget as part of the government’s annual budget package instead of medicines funding being the outcome of a complex negotiation between 20 DHBs, the medicines procurement agency and the Minister of Health.2,12
The medicines budget needs to be increased to bring New Zealand’s spending per capita in line with other comparable OECD countries.
The medicines budget has been underfunded since 2007 - investment needs to be made to ensure New Zealand patients don’t continue missing out on proven modern medicines and that New Zealand is well placed to fund innovative medicines coming down the pipeline.13-15
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Introducing a rapid access to medicines scheme would provide patients with access to effective medicines faster to ensure no patient is left waiting for a medicine they need.
Doing nothing is not an option if timely access to new medicines is important for retaining trust and confidence that publicly funded health is ‘modern’ and fit for the future.2,16