This is the text extract for InPHARMation: September 2007, browse documents here.

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From the Chief Executive

Preparing for the challenges ahead

This is the time of year when we look ahead to see what challenges lie in front of us. There is certainly no shortage of them.

Getting our priorities right to ensure the best possible use is made of the next pharmaceutical funding dollar will continue to be our central theme for the year ahead. This year we will be managing $636 million on behalf of DHBs for pharmaceutical funding, a 6% increase on 2006-07. With more medicines continuing to be used, and the continuing shift to more expensive medicines, careful choices will continue to be required for how we allocate any new funding. This, essentially, is the challenge of prioritisation. This is a growing theme internationally, as we comment in this issue of inPharmation. We also welcome this debate continuing in New Zealand, and we hope this will lead to a greater understanding of the reality of funding challenges in the health sector as a whole.

Matthew Brougham, Chief Executive (Acting)

Some of the challenges we’ve identified include: Keeping the the pharmaceutical funding application process as efficient and effective as possible. A continued increase in the cost of new pharmaceuticals Ensuring our process for examining high cost medicines is fair and stands up to scrutiny Ensuring medicines are used optimally – making the best possible use of what is already in the toolbox, rather than simply focussing on adding more tools. Improving relationships with our stakeholders.

PHARMAC - September 2007 Newsletter

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PHARMAC - September 2007 Newsletter

Medicine funding

We’ve continued to add medicines to the Pharmaceutical Schedule over the past couple of months. This year we will see more people accessing the medicines that we made funding decisions on in 2006-07. This will be one of the main drivers of the increase in pharmaceutical spending over the coming year. Some of the new investments we’ve made recently include: • Capecitabine – a chemotherapy tablet to treat colo-rectal cancer. The major advantage of this decision is that people can take the capecitabine (Xeloda) tablet at home, as it replaces a series of infusions delivered in hospitals. While being much more convenient for people being treated for colo-rectal cancer, the decision also helps free up infusion capacity at DHB hospitals. • Tiotropium – wider access to this medicine for people with chronic respiratory conditions, such as emphysema. Up to 10,000 people will be eligible for treatment over the next five years, which is an investment of some $10 million. • Herceptin – widened access to make it available for early HER2positive breast cancer. This decision, a $6 million per year investment, provides cost-effective access to a high-cost medicine for women with this form of breast cancer. Herceptin (trastuzumab) is fully funded for a nine-week course in combination with a taxane drug, such as docetaxel. • Ziprasodone – a new medicine for people with some mental illnesses such as schizophrenia or bipolar disorder. The main advantage of ziprasodone is its side effect profile, which means people don’t experience the weight gain associated with other atypical antipsychotic treatments. • Exemestane – a new hormonal treatment for women with breast cancer. Exemestane is one of the aromatase inhibitors class, and provides further choice for women and oncologists treating breast cancer.

PHARMAC model highlighted in Canadian study

Canadian researchers have cited New Zealand as an example of how negotiations with pharmaceutical companies can produce major savings on prescription medicines. Canadian health funders are struggling with a fast-growing pharmaceutical bill amid debate over a way forward. A paper by University of British Columbia researcher Dr Steve Morgan, published in Healthcare Policy journal, suggests using a New Zealand-style approach would help address the problems being faced in Canada. It examined price differences across four major classes of medicines and concluded:

“The New Zealand experience…shows that tough but fair negotiation is more powerful than regulation.”

“The results suggest that potential price savings for Canada in these drug classes are in the order of 21% to 79%. Such price differences would translate into billions of dollars in annual savings if applied across Canada.” On average, the study showed Canadian prices are 51% per cent higher than New Zealand’s in four categories of common medicines -- for cholesterol control, high blood pressure, depression and ulcers or acid reflux. “Canada can, and should, expect manufacturers of tried-andtrue medicines to price them competitively,” Dr Morgan told the Vancouver Sun. “By overpaying for these drugs, we send firms the wrong signal -that we’ll reward imitation as if it was innovation. The New Zealand experience . . . shows that tough but fair negotiation is more powerful than regulation.”

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PHARMAC - September 2007 Newsletter

Seminar Series

Our Seminar Series continues to be a popular forum for prescribers, pharmacists and all those with an interest in optimal healthcare.

The Seminar Series promotes evidence-based responses to healthcare, and is hosted and co-ordinated by PHARMAC, with an independent Board determining the subject matter and content. The Seminars cover a range of topics, not necessarily just around planned:

One Heart Many Lives

One Heart Many Lives is our social marketing response to New Zealand’s No.1 killer, cardiovascular disease. It is particularly aimed men. We’re already working with Northland and Hawke’s Bay DHBs on campaigns in their areas and further rollouts are planned. It’s now a year since we have been working with the Hawke’s Bay DHB and the campaign there, run alongside other initiatives the DHB has in place, has struck a chord with the community. This year we are adding the Lakes DHB to the One Heart Many Lives family and helping develop community-led responses in the Rotorua and lakes district.

weeks - 3 September 2007 Gastro-intestinal disorders - 17 September 2007 Practical Medicines Management - 2 October 2007 Managing Sexual problems in general practice

Flu incidence down on 2006

Figures from ESR show that Hawke’s Bay and Eastern Bay of Plenty last year. The At monitored sentinel sites, there were 792 consultations in July compared to 413 in June and 147 in May. People in Hawke’s Bay and Eastern Bay of Plenty also reported compared to 2005 when Eastern Bay of Plenty had the highest rates followed by Otago.

- 8 November 2007

Key Nutrition Messages for Newly Diagnosed Type 2 Diabetics - 7 December 2007

You can register for these seminars through the website, http://seminarseries.pharmac.govt.nz/. It is likely that, given the high level of interest, some of these seminars will be repeated in 2008 so that people aren’t disappointed.

vaccine were distributed. This was the second-highest tally on record.

See us on Health TV

Health TV is a narrowcasting service that screens in GP waiting rooms and some other larger clinics around the country. You’ll be able to see some of our promotional material for campaigns like One Heart Many Lives and Wise Use of Antibiotics screening on this service over the coming months.

usual, with a mild start to winter and most cases recorded through July and into August. campaign is continuing to promote the message that the best way About a quarter of people who consulted their doctor in July were

New Caledonia strain and the B/Malaysia strain.