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Vol 21 - November
2008
Panel discussion
A lively discussion around medicines policies involving four panellists was enjoyed by RMI members and guests in Auckland recently. Chaired by Dr Pippa MacKay, the panel was made up of PHARMAC CEO, Matthew Brougham, NZMA representative, Professor Harvey White, Eamonn Smythe represented the Access to Medicines Coalition (ATM) along with the RMI’s CEO, Ken Shirley.
Matthew Brougham outlined what he believed were the opportunities
arising out of the Medicines Strategy which was released nearly a
year ago. He suggested that on the whole, the current system
was reasonable, but that some evolutionary, rather than
revolutionary, change was occurring. One suggestion was that
PHARMAC, in the future, might not wait for companies to apply for
reimbursement, and that it might instigate the process, where a
medicine might fill a requirement.
As an
example of the evolutionary change, he cited a review of the terms
of reference for PHARMAC’s Consumer Advisory Committee and suggested
that the coalition of patient groups, the ATM, could be encouraged
to become involved. He said an announcement could be expected
after Christmas.
There
was considerable discussion about his statements that he was
agnostic to the size of the medicines’ budget and his rejection of
the notion of part subsidies. Professor Harvey White disagreed
with both statements and pointed out that partial subsidies allow
for choice particularly where side effects from medicines are
concerned.
Dr
White, who was representing the NZMA, New Zealand’s largest
pan-medical association, was concerned that PHARMAC’s sole supply
arrangements might not meet supply needs. He also echoed
earlier statements by the NZMA regarding the PHARMAC structure and
processes stating that these were not sufficiently accountable and
costs seem to dominate decision making.
Eamonn Smythe outlined the ATM’s role as advocate for a wide range
of patient groups seeking better health outcomes. The ATM, he
pointed out, represents hundreds of thousands of
patients.
Ken
Shirley noted the disappointing outcome of the Medicines Strategy
which represents a mere tweaking of the existing processes and
structures.
He
also explained that the heralded $1.3billion of savings attributed
to PHARMAC was the low fruit available to any organisation focussing
on generic substitution with global prices tumbling over the past 15
years. Other countries it seems have a better appreciation of
the positive health benefits that result from investing in modern
innovative medicines.
Election 2008  The RMI
has published and distributed a pre-election brochure outlining the
key issues together with responses by the political parties to
questions seeking clarification of their policies. For a copy click
here
The RMI Chairman, Dr Pippa MacKay said
“Our four key policy requirements are:
1. Increased investment in innovative medicines to better meet the health care needs of New Zealanders to a level that compares more favourably with other OECD nations. 2. Improved clarity and transparency in both the processes that determine the budgeted money available for publicly funded medicines and in the setting of funding priorities. 3. Increased protection of intellectual property rights in line with best practice among OECD nations. 4. An enabling regulatory framework that provides efficient and cost-competitive medicines registration, updates the out-of-date Medicines Act and which addresses the issue of PHARMAC’s exemption from Part II of the Commerce Act.” Pippa MacKay said the RMI welcomes the
National Party’s commitment to increased funding for innovative
medicines as a positive signal.
“However, the RMI, like the rest of New
Zealand, will need to wait for the outcome of the likely coalition
talks and formation of a new government, as well as a better
understanding of the implications of the global financial crisis,
before seeing any promises translated into action,” she
said. Some positive initiatives - improved PTAC transparency and accountability The new PTAC Terms of Reference released by PHARMAC last week are certainly an acknowledgement of the need for change says RMI CEO Ken Shirley. The announced changes
provide for:
- increased publication
of information
- increased clarity of
the role, scope and functions of PTAC; and
- increased clarity of
the relationship between PHARMAC and PTAC.
While these proposed
changes are steps in the right direction they will not achieve the
independence of PTAC and its separation from PHARMAC control which
is considered necessary by the RMI and other key
stakeholders.
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Stop Press National's pledge to boost funding for subsidised medicines by an extra $180m over three years is a significant advancement. Many innovative medicines that have received a positive recommendation by PTAC but to date have not been funded should now become available to New Zealanders. While this policy represents a signficiant improvement it will still leave New Zealand well behind most other OECD countries in access to innovative medicines.
Low and
slow confirmed
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