Towards
a New Zealand Medicines Strategy
Meaningful and worthwhile reforms to assessment
and procurement of medicines in New Zealand would result in
better health outcomes for many thousands of people with
disease or disability.
So, what will the New Zealand
Medicines Strategy, much-vaunted by Hon Peter Dunne, look like
when it is published sometime before Christmas? |
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Will there be any real
meat amongst the expected overarching strategic policy
framework?
This is the question patient groups,
clinicians, individuals and the pharmaceutical industry are
asking themselves.
There are a variety of guesses built
on hints and speculation. These range from “a minor tweak” to
the existing regime stated by an official to the “real and
meaningful reforms” hoped for by most.
The consensus
seems to be that there will be: |
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Considerable attention given to the “optimal use
of medicines” end of the spectrum as that is where the focus
of Mr Dunne’s consultation document lay.
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Some attempts to make the funding of medicines a little
more transparent than it is at present, and,
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Perhaps some addition to the budget for the community
pharmaceutical schedule as a nod towards improving access to
medicines. |
“Despite the fact that the majority of the
submissions on Mr Dunne’s consultation document were concerned
with New Zealanders access to new and innovative medicines, we
suspect that access to medicines issues will be left in the
‘too hard’ basket,” Dr Pippa MacKay the chair of the
Researched Medicines Industry Association speculated.
“It’s a matter of political will. While Peter Dunne
struggles to achieve as much reform as he can win from his MMP
partners, there is little sign outside his office that
positive reforms are in the wind,” she commented.
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What
should be in the Strategy?
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New Zealanders do not enjoy a similar access
to modern and innovative medicines as do citizens in other
OECD countries. Patient groups, clinicians and researchers all
emphasised this serious problem in their submissions towards
the development of a New Zealand medicines
strategy.
Rationing of medicines, indeed all health
resources, is a given, however the pharmaceutical industry
believes the Strategy should ensure that funding and rationing
decisions are made openly,
transparently and
explicitly.
The process of funding of
medicines is flawed with very apparent weaknesses. These mean
neither the Government nor the public have any base for
confidence in the quality of the decision-making, let alone
the outcomes.
The pharmaceutical industry has compared
the existing institutional arrangements for access to
medicines in New Zealand with international best practice, and
with the practice in other areas of public policy in New
Zealand.
This comparison showed that the
structures and processes involved in the key decisions about
the reimbursement (inclusion on the community schedule for
subsidy) of pharmaceuticals are inferior to the standards
expected of government institutions.
To move
from current practices to an improved model filling the
expected standards criteria the industry has recommended to
Government the following reforms to the funding process:
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Separation of cost effectiveness decisions
from funding decisions |
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Separation of medical and scientific decisions from
funding and procurement decisions |
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Creation of reliable metrics and reporting
requirements |
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Improved decision-making
processes | |
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What did others say about the
consultation around the New Zealand Medicines
Strategy?
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Cancer
Society
“The Cancer Society of New Zealand
submits that the consultation document will do nothing to
improve the lot of cancer patients in New Zealand. It will
certainly not provide the modern pharmaceuticals we see in
other parts of the developed world in a timely and appropriate
fashion.
“Indeed the basic flaw in the document is that
it presumes that the existing processes, systems and
structures for the provision of pharmaceuticals to New
Zealanders are adequate, and that they actually support the
quality, access and optimal use of medicines.
“We submit
that this is simply untrue.”
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