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Vol 22- April
2009
Government
moves fast, what next?
 The new Government moved
fast to implement its promises in its first 100 days. In the
medicines area we saw access for Herceptin implemented along with
confirmation of the promised increase in
funding. Now
that the first rush of promises has been fulfilled, the Industry is
looking forward to the next actions.
RMI
Chairman, Dr Pippa MacKay, said there are a number of reforms around
Medicines New Zealand, the national medicines strategy, that could
be implemented even in these times of economic and financial
restraint.
“We
are eagerly awaiting signals that the strategy’s promise that DHBs
and PHARMAC would move to principle-based budget setting with
the aim of maximising health outcomes across pharmaceutical and
other health services.
“Hopefully this will occur this year when the additional $40m of new
spending is allocated,” Dr MacKay said.
“A
principles-based approach could provide considerable advances in
terms of transparency as well as productivity if equal scrutiny were
applied to economic as well as clinical benefits and risks to both
pharmaceutical and non-pharmaceutical
investments.
“The
number of medicines given a high priority for funding by PTAC
suggests there are several medicines available that could provide
cost savings in other areas of health. This could be in terms
of getting people back to work, reducing the need for carers, or
simply avoiding the costs of expensive hospitalisation and invasive
therapies,” she commented.
“The
RMI, and I imagine a number of other stakeholders, were planning to
canvass issues, such as this at the planned March PHARMAC
stakeholder forum.
“Now
that this has been postponed indefinitely, a useful opportunity to
discuss the implementation of the medicines strategy with the wider
group of stakeholders has been lost for the
moment.
“This
was an opportunity to share ideas and concerns, particularly around
the sensitive area of transparency of process,” she
said.
John
Forman, the Access to Medicines Coalition spokesperson agreed.
“We are all waiting to see what the Government will do on a number
of fronts, not the least being their promised look at high cost
medicines. The forum would have been a positive initiative
where we could have shared information, and perhaps provided some
guidance to PHARMAC regarding its advice to the Health
Minister.”
Better than none at all ...
In the last RMI newsletter we reported that National’s election
pledge to boost funding for subsidised medicines by an additional
$180m over the next three years was a significant
advancement.
While details on how the
funding will apply are not yet completely clear, the RMI believes
that any increase in funding during the recession is a plus.
“Any increase is welcomed as being better than none at all,”
commented RMI Chief Executive, Ken Shirley.
The additional $180m over
three years is a first small step towards closing the gap between
New Zealand’s level of investment in modern medicines and that of
other OECD countries, notably Australia.
However, while sounding
generous, the reality of the increase is that the $180m over the
next three years appears to be from a fixed base so instead of an
additional $40m, $60m and $80m in years one, two and three
respectively, there will be $40m, $20m and $20m, additional in years
one, two and three.
The situation is
compounded by a relatively large adjustment in year one ($40m)
followed by two years of minimal adjustment ($20m in years two and
three).
Additional funding for medicines  The RMI
expects that PHARMAC and RMI members will be extremely busy
arranging contracts to accommodate the $40m in year one and suggests
that all could then be under considerable constraint in years two
and three.
A complication
could arise with the DHBs holding the budget for community
medicines. PHARMAC operates on a “use it” or “lose it” basis with no
scope for carry-over to subsequent years. The RMI is hopeful
that given the unusual situation, that some form of carry-over could
be introduced as a “one-off”.
International philanthropy The pharmaceutical industry’s philanthropic activities
are wider than might be expected and is a leading force in improving
access to cures for disease worldwide.
Programmes are usually conducted in co-operation with
NGOs and international health and relief groups are often deployed
in those places and against those diseases that most desperately
need attention, particularly in sub-Saharan Africa.
These diseases include, but are not limited to, HIV/AIDs,
tuberculosis and malaria.
• HIV/AIDS – Many companies donate HIV testing kits free
of charge or at cost to countries plagued by this disease.
Other companies provide millions of dollars in donations to support
HIV/AIDS research in Africa, build laboratories and train health
care workers. One programme, the Step Forward...for the
World’s Children partners with national, regional and local
governments and NGOs in order to improve local health care and
infrastructure, meet basic community needs (such as improving
sanitation and providing clean water) and strengthening local
schools.
• Tuberculosis – Pharmaceutical companies are also
involved directly in a number of global initiatives to combat the
spread of TB. The Global Alliance for TB Drug Development is
accelerating the discovery and development of cost-effective new
drugs to shorten and simplify treatment of TB. The Stop TB
Partnership, another example, is a partnership to which a number of
companies contribute in order to expand, adapt and improve
strategies to control and eliminate TB.
• Malaria – There are a number of initiatives by
pharmaceutical companies aimed at reducing, and ultimately
eliminating, the number of malaria cases. Contributions
include funding and the provision of medicines to the WHO
Distribution Partnership at cost for use in developing
countries.
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News updates US R&D
Update
A record $US65.2 billion was invested by
US pharmaceutical research and biotechnology companies in the
research and development of new life-changing medicines and vaccines
in 2008. This is an increase of roughly $US2 billion over
2007, according to analysis by the Pharmaceutical Research and
Manufacturers of America (PhRMA) and Burrill &
Company.
There are more than
2,900 medicines in development in the US, including 750 compounds
for cancer, 312 for heart disease and stroke, 150 for diabetes, 109
for HIV/AIDs and 91 for Alzheimer’s disease and
dementia.
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