Health advocates hail govt reform for Pharmac

Health patient advocates say the government's plan to reform the country's drug-buying agency, Pharmac, is long overdue.

The minister responsible for Pharmac, David Seymour, has sent a letter of expectations to the board, including improvements to its culture and stakeholder engagement.

Seymour also told Pharmac it was inappropriate for the government agency to keep considering Te Tiriti o Waitangi's place in the health sector.

Patient Voice Aotearoa Chair Malcolm Mulholland says while they welcomed Seymour's letter of expectations to Pharmac, "it was never clear to advocates as to how The Treaty of Waitangi was applied to the decisions that were being made.

"From myself and other patient advocates, the letter of expectation was pleasing," Mulholland told Pacific Mornings' William Terite.

"It signalled, I think, the era of reform, and it looked to address many of the concerns that we've been raising over the past five years."

Watch Malcolm Mulholland's interview below.

The Pharmaceutical Management Agency, Pharmac, was established in 1993 as a government entity that decides, on behalf of Te Whatu Ora, Health New Zealand, which medicines and pharmaceutical products are subsidised for use in the community and public hospitals.

In his letter to the new Pharmac board chair, Paula Bennett, Seymour said the agency's role should focus on delivering improved health outcomes underpinned by robust data and evidence, by its statutory responsibilities.

The minister said this should serve all New Zealanders based on actual need, without assigning their background as a proxy of need.

He also said while the Treaty was a distraction, there was no proof Te Tiriti led to bad health outcomes.

Mulholland said he believed Pharmac reforms would benefit Māori and Pacific people.

"If I look back at Te Tiriti being a part of the framework by which they were making decisions whether or not to fund a drug, it was never clear to us how that was being done.

"In a very natural way, it resulted in more Māori accessing more medicines. So that was really our bugbear, how it was being applied, and how it was actually benefiting Māori. I would expect that.

"What I would say is that one of the big shifts, if you like, is talking about revisiting the health technology assessment process within Pharmac. That's how they're making decisions about what drugs they should and should not fund.

"One of the things that's very clear in the letter of expectations is that the Minister wants Pharmac to consider what some of the cost is within the health system of not funding a drug or funding a drug as well as the societal impact. And that's a more holistic view.

"I would probably argue that it's more of a Māori or indigenous way of looking at, you know, those types of issues," Mulholland said.

Bennett said improvements to the agency's culture would not happen overnight, but she was positive about change.

Pharmac has often been criticised for being 'defensive' and lacking transparency.

Bennett said Pharmac would have to prove that the culture had changed, adding the expectations from the government were clear, and progress would be step-by-step.

Mulholland said patient advocates would welcome positive changes at Pharmac "because if you take the impact of funding or not funding drugs, say they're looking to fund an oral drug, perhaps over something that's administered intravenously, then one could argue that's a saving on the health system.

"And that would mean that when Seymour gets around the cabinet table, he would have more of an argument to give Pharmac the money to fund the drug.

"In that regard, I think it will have a positive outcome. I think you'll see Pharmac receive more funding, and patients will receive more medicines."

Watch the Minister for Health and Pacific Peoples, Shane Reti's, interview below.