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KEY INFORMANTS’ PERCEPTIONS OF HOW PHARMAC OPERATES IN NEW ZEALAND

Published online by Cambridge University Press:  12 October 2012

Rajan Ragupathy ,
June Tordoff ,
Pauline Norris  and
David Reith
Rajan Ragupathy
Affiliation:
School of Pharmacy, University of Otago email: rajan.ragupathy@gmail.com
June Tordoff
Affiliation:
School of Pharmacy, University of Otago
Pauline Norris
Affiliation:
School of Pharmacy, University of Otago
David Reith
Affiliation:
Dunedin School of Medicines, University of Otago
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Abstract

Objectives: The aim of this study is to examine key informants’ perceptions of how the New Zealand Pharmaceutical Management Agency (PHARMAC) operates in New Zealand.

Methods: We carried out qualitative analysis of semi-structured interviews with key informants. We obtained ethics approval from the University of Otago School of Pharmacy, and all participants gave informed consent. We digitally recorded the interviews, which were then transcribed, and coded in NVivo. The data were analyzed by theme using constant comparison methods. Twenty informants who had previously published research or commentary on New Zealand's access to medicines, acted as spokespersons for interest groups, or held positions that gave them key insights into New Zealand's medicines system agreed to participate. Informants were purposefully selected to ensure a wide range of views, including five people working in medicine, four in pharmacy, three Members of Parliament from different parties, and two each from PHARMAC and the pharmaceutical industry.

Results: Respondents saw PHARMAC as an organization that contained medicine costs effectively, was politically neutral, and resistant to lobbying. It enjoyed broad political support and, with extremely rare exceptions, had been allowed to carry out its functions independently regardless of who was in government. As a result of this political stability, the relationship between PHARMAC and the pharmaceutical industry has been improving.

Conclusion: PHARMAC's longevity and increasing influence are largely due to political choices made to prioritize containing pharmaceutical expenditure and to respecting PHARMAC's independence. This may be difficult to replicate in other countries.

Keywords

Pharmaceutical policyPharmaceutical economicsHealthcare rationingNew Zealand
Type
POLICIES
Information
International Journal of Technology Assessment in Health Care , Volume 28 , Issue 4 , October 2012 , pp. 367 - 373
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

1.Aaltonen, K, Ragupathy, R, Tordoff, J, Reith, D, Norris, P. The impact of pharmaceutical cost containment policies on the range of medicines available and subsidized in Finland and New Zealand. Value Health. 2010;13:148–156.CrossRefGoogle ScholarPubMed
2.Australian Department of Health and Ageing. National Medicines Policy 2000. http://www.health.gov.au/internet/main/publishing.nsf/Content/0241A32640D477CACA256F18004685E4/$File/nmp2000.pdf (accessed April 28, 2012).Google Scholar
3.Begg, E, Sidwell, A, Gardiner, S, Nicholls, G, Scott, R. The sorry saga of statins in New Zealand- pharmacopolitics versus patient care. N Z Med J. [serial on the Internet] 2003. http://www.nzma.org.nz/journal/116-1170/360/ (accessed April 28, 2012).Google Scholar
4.Braae, R, McNee, W, Moore, D. Managing pharmaceutical expenditure while increasing access- the Pharmaceutical Management Agency (PHARMAC) experience. Pharmacoeconomics. 1999;16:649–660.CrossRefGoogle ScholarPubMed
5.Business and Economic Research Limited (BERL). Independent review of The Castalia Report on New Zealand Pharmaceutical Policies. [Online] 2005. http://www.pharmac.co.nz/2006/05/04/040506b.pdf (accessed April 28, 2012).Google Scholar
6.Castalia Strategic Advisors. New Zealand pharmaceutical policies: Time to take a fresh look. [Online] 2005. http://www.castalia-advisors.com/files/14634.pdf (accessed April 28, 2012).Google Scholar
7.Cumming, J, Mays, N, Daubé, J. Analysis: How New Zealand has contained expenditure on drugs. BMJ. 2010;340:c2441.CrossRefGoogle Scholar
8.Davis, P.“Tough but fair”? The active management of the New Zealand drug benefits scheme by an independent Crown agency. Aust Health Rev. 2004;28:171–181.CrossRefGoogle ScholarPubMed
9.Easton, B. New Zealand's pharmaceutical policies: A fresh look. [Online] 2005. http://www.pharmac.co.nz/2006/05/04/040506a.pdf (accessed April 28, 2012).Google Scholar
10.Faunce, T, Bai, J, Nguyen, D. Impact of the Australia-US free trade agreement on Australian medicines regulation and orices. J Generic Med. 2010;7:18–19.CrossRefGoogle Scholar
11.Isaacs, RJ, Frampton, CM, Kuper-Hommel, MJ. PHARMAC's funding of 9 weeks Herceptin: Many assumptions in a high-risk decision. N Z Med J. [serial on the Internet] 2007. http://www.nzma.org.nz/journal/120-1259/2676/ (accessed April 28, 2012).Google Scholar
12.Lancet Editorial. New 50 million cancer fund already intellectually bankrupt. Lancet. 2010;376:389.CrossRefGoogle Scholar
13.Lee, TH, Emanuel, EJ. Tier 4 drugs and the fraying of the social compact. N Engl J Med. 2008;359:333–335.CrossRefGoogle ScholarPubMed
14.McCormack, P, Quigley, J, Hansen, P. Report to Minister of Health, Hon Tony Ryall- Review of access to high cost, highly specialised medicines in New Zealand. [Online]. http://img.scoop.co.nz/media/pdfs/1005/Review_of_Access_to_High_Cost_Highly_Specialised_Medicines_31_April_2010.pdf (accessed April 28, 2012).Google Scholar
15.Metcalfe, S, Rodgers, A, Werner, R, Schousboe, C. PHARMAC has no cost-effectiveness threshold. N Z Med J. [serial on the Internet] 2012. http://journal.nzma.org.nz/journal/125-1350/5083/ (accessed April 28, 2012).Google Scholar
16.Moodie, P, Metcalfe, S, McNee, W. Response from PHARMAC: Difficult choices. NZ Med J. [serial on the Internet] 2003. http://www.nzma.org.nz/journal/116-1170/361/ (accessed April 28, 2012).Google Scholar
17.Moodie, P, Metcalfe, S, Poynton, M. Do pharmaceutical score cards give us the answers we seek? NZ Med J. [serial on the Internet] 2011. http://journal.nzma.org.nz/journal/124-1346/4976/ (accessed April 28, 2012).Google Scholar
18.Moynihan, R. New Zealand agency comes under pressure to pay more for drugs. BMJ. 2011;342 doi:10.1136/bmj.d3933.Google ScholarPubMed
19.New Zealand Ministry of Health. Medicines New Zealand. [Online]. http://www.health.govt.nz/publication/medicines-new-zealand (accessed April 28, 2012).Google Scholar
20.New Zealand Parliament. New Zealand Public Health And Disability Act 2000 [Online] 2000. http://www.legislation.govt.nz/ (accessed April 28, 2012).Google Scholar
21.New Zealand Pharmaceutical Industry Taskforce. Submission on the Towards a New Zealand Medicines Strategy consultation document. Wellington: New Zealand Pharmaceutical Industry Taskforce; 2007.Google Scholar
22.Pearson, SD, Rawlins, MD. Quality, innovation and value for money: NICE and the British National Health Service. JAMA. 2005;294:2618–2622.CrossRefGoogle ScholarPubMed
23.Ragupathy, R, Aaltonen, K, Tordoff, J, Norris, P, Reith, D. A 3-dimensional view of access to licensed and subsidized medicines under single payer systems in the United States, United Kingdom, Australia and New Zealand. Pharmacoeconomics (in press). 2011.CrossRefGoogle Scholar
24.Ryall, T. Government extends Pharmac role. [Online]. http://www.beehive.govt.nz/release/government-extends-pharmac-role (accessed April 28, 2012).Google Scholar
25.Taylor, L. Australian govt blocks subsidies of new drugs. PharmaTimes Online [serial on the Internet]. 2011. http://www.pharmatimes.com/Article/11-03-15/Australian_govt_blocks_subsidies_for_new_drugs.aspx (accessed April 28, 2012).Google Scholar
26.The United Kingdom Department of Health. The Pharmaceutical Price Regulation Scheme 2009. [Online]. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_091825 (accessed April 28, 2012).Google Scholar
27.Wonder, M, Milne, R. Access to new medicines in New Zealand compared to Australia. NZ Med J. [serial on the Internet] 2011. http://journal.nzma.org.nz/journal/124-1346/4966/ (accessed April 28, 2012).Google Scholar