This is the text extract for Te Whaioranga Maori Responsiveness Strategy overview, browse documents here.

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New Zealand’s approach to addressing health inequalities for access to medicines.

Te Whaioranga – PHARMAC Māori Responsiveness Strategy

He aha ai – Why did PHARMAC develop this strategy

The founding constitutional document of New Zealand - The Treaty of Waitangi outlines the special relationship between Māori and the Crown and the obligation to ensure that Māori people are supported to achieve their maximum health and wellbeing Māori health is a New Zealand health priority area and PHARMAC’s Māori Responsiveness Strategy outlines how PHARMAC will contribute to this.

Māori Responsiveness Strategy: A Summary

The 2002 Māori Responsiveness Strategy had six strategic goals: 1. Incorporate Māori strategic priorities. 2. Improve human resources. 3. Improve ethnicity data collection and analysis. 4. Improve our performance in negotiating with suppliers and assessing new drug applications. 5. Improve our performance in informing Māori about available subsidised medicines. 6. Improve Māori representation and participation.

These goals have been updated taking into account the progress PHARMAC has made in relation to Māori Health.

How did we develop the Māori Responsiveness Strategy

1. Identify the problem 2. Understand the wider sector policy frameworks 3. Conduct an analysis of existing internal accountability documents / frameworks and understanding by the Board, Senior Managers and all staff of Māori health issues 4. Draft a consultation document 5. Conduct extensive community based consultation with participation by all PHARMAC staff, Board members and Senior Managers 6. Publish the strategy and review progress annually

The 2007 – 2012 goals build from the original 2002 goals, they are:

1. Integrate Māori strategic priorities. 2. Enhance internal PHARMAC capability in relation to Māori Health issues. 3. Improve the quality of data analysis in relation to Māori Health. 4. Prioritise Māori health priority areas in Funding & Procurement. 5. Advance Optimal Use of Medicines for Māori. 6. Ensure significant Māori representation and participation within PHARMAC.

What is the extent of the problem?

PHARMAC has been concerned for some time that the benefits of subsidized pharmaceuticals are not reaching Māori at the same rates as other New Zealanders. The following table provides an insight into where the gaps lie in relation to medication use of the Māori population for nationally subsidised medicines. This graph has been adjusted for age and burden of disease (Disability Adjusted Life Years – DALYs) relevant to New Zealand’s Pharmaceutical Schedule. The graph indicates large deficits in use of medication by the Māori population for antibacterials (antibiotics) and cardiovascular medications such as lipid modifying agents. There are small areas where excess use of medicines by the Māori population occurs: Anti-Parkinson agents, Alpha Adrenoceptor Blockers and other musculoskeletal medications.

-100,00 -50,00 CVS Rx incl anti brinolytics/antithrombotics, LMAs, smoking cessation [cardiovascular] antibacterials [bacterial infections (incl septicaemia)] Metabolic/endocrine [other endocrine/metabolic]

PHARMAC Vision, Mission and Values

The PHARMAC vision is Leading Edge Medicines Management, the Te Whaioranga goal in relation to the vision is; Māori have the right to the right medicine, at the right time, for the right price and with the right information to understand how to use medicines.

0

50,00

100,00

150,00

200,00

Figure 3:

Gaps in Māori use of medicines, after adjusting for age and burden of disease (need) relevant to the Pharmaceutical Schedule

deficits (+) or excess (-) in Rx uptake (no. scripts) by Māori, adjusted for age and relative disease burden (DALY loss)

Antidepressants [depression (incl suicide)] Antiulcerants [Peptic ulcer disease] Diabetes Rx etc [Diabetes mellitus] Rx for osteoporosis [Osteoporosis] Rx used for cancers [cancers] Rx for asthma &/or CORD [asthma/CORD] other neurol Rx [other neurological] other alimentary Rx [other GI/hepatic] Antiepilepsy Drugs [Epilepsy] ADHD Rx [Childhood conduct disorders] Anxiolytics [Anxiety disorders] Glaucoma Preparations [Glaucoma] other antiinfectives [other infectious diseases] Antipsychotics [Schizophrenia] other eye Rx [other sensory] Rectal and Colonic Anti-in ammatories [In ammatory bowel disease] Antianaemics [Spina bi da] Cytotoxic Immunosuppressants [renal (non DM)] Other Immunosuppressants [renal (non DM)] Antituberculotics and Antileprotics [Tuberculosis] Nasogastric/Gastrostomy Tube Feed: Paediatric Products [Low birth weight] Antiretrovirals etc. [HIV/AIDS] Rx for cirrhosis [Cirrhosis/ other chronic liver disease] lithium [Bipolar a ective disorders] naltrexone, disul ram [Substance use disorders] Hepatitis B/C treatments [Hepatitis] Antirheumatoid Agents [Rheumatoid arthritis] Multiple Sclerosis Treatments [MS and other demyelinating conditions] Cystic Fibrosis [Chronic respiratory diseases NEC] erythropoietin, other Rx for CRF [renal (non DM)] Antiparkinson Agents [Parkinson’s disease and other movement disorders] Alpha Adrenoceptor Blockers used mainly for BPH [BPH] NSAIDS/gout/analgesics/muscl relxnts [other musculoskeletal] at 0, Māori usage = non-Māori after accounting for di erences in age and burden of disease