Lie Down For Life protesters, calling for increased funding and a review of Pharmac. Photo / Mark Mitchell
Lie Down For Life protesters, calling for increased funding and a review of Pharmac. Photo / Mark Mitchell
Pharmac has released priority lists for all funding applications for medicines it has assessed but not yet funded for the first time.
The Government drug-buying agency has been criticised for a lack transparency in how it decides which medicines to fund.
Chief executive Sarah Fitt said the list had not been shared previously as Pharmac thought it could affect negotiations with suppliers.
"But we know people are interested in what applications we are actively considering, and we want to be more transparent.
"As a government entity, it's important that we are as open as we can be. This includes letting people know where funding applications are at in the Pharmac process."
The "options for investment" list includes all the applications that would be funded if Pharmac had the budget for them. There are 102 applications on this list covering 71 medicines and related products.
Some applications on the list are for new medicines and some are for medicines already funded that Pharmac would like to fund for wider use for more patients.
The preferential ranking Pharmac gives to applications on this list is determined using Pharmac's decision-making framework, the Factors for Consideration.
"We think more widely than just the individual patient and the cost of the medicine," Fitt said.
"We need to understand the full effect our decisions would have. Our expert advisers help us with the clinical aspects and our health economists identify the benefits and costs to the whole health system, patients and their whānau."
Pharmac chief executive Sarah Fitt. Photo / Jason Oxenham
Some information was kept confidential so Pharmac could negotiate the best prices for medicines, she said.
"If pharmaceutical companies knew how much we wanted to fund a medicine, it could make it harder for us to negotiate the best deal possible."
The "only if cost neutral or cost saving" list includes applications that may get funded if Pharmac can negotiate a deal that saves money, or at least doesn't cost more.
"Our clinical experts help us assess whether an application delivers more benefits than treatments we already fund," Fitt said.
"If they think a treatment would not deliver better health outcomes than those already available, it is generally placed on our cost neutral or cost saving list."
Pharmac doesn't rank applications on this list in preferential order. It will consider negotiations with any supplier who offers cost neutral or cost saving pricing.
The "recommended for decline" list generally includes applications that Pharmac's expert clinical advisers have suggested Pharmac turns down.
Often this is because these medicines would add no value or are harmful. Pharmac does not actively work on these applications.
"People should have more certainty of information about applications, even if this is a decision to decline funding," Fitt said.
"To make our approach clearer, we have been working through this list to formally decline a number of items on it."
The three priority lists help Pharmac compare and make decisions on the 85 or so funding applications it receives every year.
"Every year, our fixed budget must pay for all the medicines that are already funded. If there is money left over or we receive a budget increase, we use this to fund new medicines or widen access to treatments we already fund," Fitt said.
If a funding application was not on one of the priority lists, it was still under assessment, she said.
"We work hard to negotiate some of the best prices for medicines in the world and we follow a rigorous process to ensure all applications are thoroughly and fairly assessed.
"By making our lists easily available, we hope that New Zealanders will have more clarity about where applications are at that we have completed our assessment of but are not yet funded."
