PHARMAC’s Regional Forum
Otahuhu: 14 September 2011
Rotorua: 28 September 2011
Christchurch: 4 October 2011
Taupo: 11 October 2011
North Shore: 12 October 2011
Porirua: 25 October 2011
Agenda
• Welcome
• Introduction to PHARMAC
• Connecting and communicating with health consumers
• Review of Te Whaioranga
• PHARMAC’s Pacific Responsiveness Strategy
• Q&A session
• Wrap up
Pharmaceutical Management Agency
How medicines are funded in New Zealand
What is PHARMAC?
•
Set up in 1993 to manage public spending on prescription medicines
•
PHARMAC legislative objective:
•
To secure for eligible people in need of pharmaceuticals the best health outcomes
that are reasonably achievable from pharmaceutical treatment and from within the
amount of funding provided.
PHARMAC’s budget
Annual health budget – almost $14 billion
(determined by the Minister of Health)
Community and cancer medicines
managed by PHARMAC and paid by DHBs - $777 million
(determined by the Minister of Health)
DPF
Managed and paid by PHARMAC
1-2% of pharmaceutical budget.
What do we do?
•
Manage the Pharmaceutical Schedule
•
The subsidy for each item on the
list (not the price)
•
Conditions of use
(to access subsidy)
•
Help hospitals manage pharmaceutical
spending
•
Manage special access programmes
(Panels, Exceptional Circumstances)
Our place in the health sector
Patient
Our place in the health sector
Patient
Prescriber
Our place in the health sector
Patient
Prescriber
Our place in the health sector
Patient
Prescriber
Pharmacist
Our place in the health sector
Full price
Patient
Prescriber
Co-payment
Pharmacist
Our place in the health sector
Full price
Patient
Prescriber
Co-payment
Pharmacist
Pharmaceutical
companies
Our place in the health sector
Full price
Patient
Prescriber
Co-payment
Pharmacist
20%
Pharmaceutical
companies
Our place in the health sector
Full price
Patient
Prescriber
Co-payment
80%
Pharmacist
20%
Pharmaceutical
companies
Funding Decisions
•
PHARMAC Board
PTAC
Is there a reason to fund this medicine?
•
Safer or more effective alternative?
•
More cost effective than alternatives?
•
Are there sufficient funds?
•
Is this the best way to spend the money
Public consultation
we have?
PTAC
•
Economic assessments are conducted
in-house.
•
PHARMAC
PTAC (Pharmacology & Therapeutics
Advisory Committee) and its
subcommittees provide independent
Medsafe
Medicine supplier
clinical advice to PHARMAC.
•
PHARMAC Board (or staff under
delegation) make all funding decisions.
PHARMAC Decision Criteria
1.
Health needs of eligible people
2.
Health needs of Māori and Pacific peoples
3.
Availability and suitability of existing pharmaceuticals and other therapies
4.
Clinical benefits and risks
5.
Cost effectiveness (compared to purchasing other health care and disability
services)
6.
Overall budgetary impact (both pharmaceutical and total health budget)
7.
Direct cost to health service users
8.
Government priorities for health funding/Government objectives
9.
Other criteria (with appropriate consultation)
We also promote the responsible use of medicines
•
Encourage responsible use – Access and Optimal Use Team
•
Help to implement major decisions affecting many people
•
•
Special Foods
Contract with external parties for supply of education programs and resources for GPs
•
BPAC
•
Promote PHARMAC at conferences
•
Develop and supply resources for consumers
•
•
Gout
•
“Practical tips for giving medicine to kids”
Resources, including in a variety of languages, can be ordered free from
www.pharmaconline.co.nz
What we don’t do
•
Buy and/or sell drugs (pharmaceutical suppliers, wholesalers, pharmacies)
•
Make or store drugs (pharmaceutical manufacturers and wholesalers)
•
Write out cheques for drugs supplied to patients (DHBs)
•
Set budget (Minister)
•
Approve drugs for use in New Zealand (Medsafe)
Consumer Advisory Committee
•
Advises PHARMAC with input
from a consumer or patient point
of view
•
Helps PHARMAC establish
relationships with consumers,
better communicate with
consumers and ensure consumer
perspectives taken into account
•
•
•
•
PHARMAC Board
PTAC
Public consultation
Regional Forums
Currently 9 members from
various consumer health sectors
across the country
PTAC
PHARMAC
Not intended to be representative
of all consumers
Medsafe
Visit
http://www.pharmac.govt.nz/CAC
Medicine supplier
Challenges
•
We have a fixed budget and could never fund all the medicines available for
all people (unique to New Zealand)
•
A fixed budget requires prioritisation of medicines spending
•
Conflicting pressures come from advocacy groups, clinician groups, media,
patients, pharmacists and pharmaceutical companies
•
Whatever we do we will never please everyone, but we do need to have a
system that is robust and regarded as fair
Questions?
Connecting and communicating with
health consumers
Information and services
What kinds of medicines information and services do you need?
What kind of information and services would you like to get from
PHARMAC?
Could these services be delivered on line?
What do you expect to do or find online?
Discussion and questions
PHARMAC’s Māori Responsiveness Strategy
Action Plan
Te Tiriti o Waitangi
Principles

Partnership

Protection

Participation
Goal
To ensure that Māori have:

Access to subsidised medicines

The knowledge to use these medicines safely and appropriately
History of the Māori
Responsiveness Strategy
2001: 15 consultation hui
2002: Māori Responsiveness Strategy I
2007-2012: Māori Responsiveness Strategy II
2012-2017: Māori Responsiveness Strategy III
PHARMAC survey
Key points from hui

“there are barriers to accessing health professionals – cost, attitude to
Māori, being treated as a number”

“patients are not provided with sufficient information from chemists”

“you aren’t told everything and you can’t ask what you don’t know”

“chemist labels are confusing and hide the contents of the medicine”

“Confusion around trade names versus generic medicines”

“Medications need to be explained”

“Print on small bottles are too little to read”

“Kaumatua do not like to ask questions and are sometimes treated like
they are thick”

“Māori are unsure of medicines – there is an air of mistrust and often
they just need understanding”
Māori Responsiveness Strategy
–
Māori strategic priorities
–
Internal capability
–
Data collection and analysis
–
Funding and procurement
–
Information on subsidised medicines and optimal use
–
Māori representation and participation
PHARMAC commitment to Māori Health
www.hrphow.co.nz
•
He Manawa Tahi Koiora Tini
•
Cardiovascular Disease – key priority
•
Tane Ora – Māori and Pacific Island men 35+ years
•
Māori and Pacific Island men die of heart disease, 10-14 years earlier than
non-Māori and non-Pacific Island men
•
www.oneheartmanylives.co.nz
•
Asthma is the leading cause of childhood admissions to hospital
•
Māori and Pacific people are more likely to be hospitalised for asthma and
have more severe chronic symptons
•
The ratio of SABA to ICS dispensings is higher in Māori and Pacific children
•
www.spacetobreathe.co.nz
He Wā Pātai / Whakawhiti Kōrero hoki
•
http://www.iwiora.co.nz/feedback
Discussion
PHARMAC’s
Pacific Responsiveness Strategy
The Pacific Strategy
•
•
Informing development of the Pacific Responsiveness Strategy:
•
2006 – informal advisory group of Pacific health stakeholders
•
Stocktake
•
Improve capability
•
Raise awareness of PHARMAC’s role in Pacific health
•
Develop and strengthen relationships
•
Formalise a strategy
Strong CAC support and input.
The Pacific Strategy
•
Māori and Pacific health needs are decision criterion 2.
•
Pacific peoples are a significant population in NZ and face some
significant health disparities and barriers.
•
Focuses efforts on:
•
Developing an understanding of Pacific health issues
•
Building networks and relationships
•
Targeting AOU campaigns
•
Connecting to broader government and health sector initiatives
Your input
•
What are the major issues for Pacific peoples with regards to
medicines?
•
How can PHARMAC help to address these issues?
•
How can PHARMAC best connect and communicate with Pacific
leaders and health workers in your community?
•
And more…
Discussion
Thank you for attending the PHARMAC
Regional Forum