This is the text extract for Our Place in the Medicines System, browse documents here.

---

PHARMAC Information sheet

Our place in the medicines system

Our roles

PHARMAC has four main roles. These are: • managing the Pharmaceutical Schedule, the list of government-subsidised medicines • promoting the optimal use of medicines • managing subsidies on medicines and related products for public hospitals • managing the Exceptional Circumstances programmes. We can also engage in research relevant to our work.

Our Relationships

We interact with a wide range of organisations in the health sector.

Minister of Health

We report directly to the Minister of Health, which includes meeting with the Minister and providing regular reports and briefings. The Minister is ultimately responsible for PHARMAC’s performance and, among other things, appointing the PHARMAC Board and setting expectations of PHARMAC.

Medicines New Zealand

The Government’s strategy for the medicines system, Medicines New Zealand, provides an overall framework for PHARMAC’s operations. The strategy, published in 2007, is intended to inform decision-making over the long term and to deliver a world-class medicines system for New Zealanders. The strategy was accompanied by an action plan, Actioning Medicines New Zealand. We’re committed to implementing the work identified in Actioning Medicines New Zealand to ensure the aims of the strategy are met.

Parliament and MPs

As a Crown Entity we are accountable to Parliament for our actions and must respond to Parliamentary Questions (questions asked about our operations by Members of Parliament). PHARMAC’s performance is also scrutinised by Parliament’s Health Select Committee. PHARMAC also assists MPs with queries from their local constituents.

District Health Boards (DHBs)

DHBs hold the funding for most health services provided by the Government, including the Community Pharmaceutical Budget. To manage this budget, PHARMAC works on behalf of DHBs to negotiate prices for medicines, set subsidy levels and conditions, and ensure spending stays within budget. PHARMAC also helps DHBs negotiate prices for some medicines used in hospitals. District Health Boards have also sought PHARMAC’s help – using our procurement skills and experience – to manage procurement of some other hospital products. PHARMAC manages a list of pharmaceutical cancer treatments (the cancer treatments `basket’), which all District Health Boards must fund. While PHARMAC assesses what medicines to add to the list, funding continues to be held by District Health Boards.

The funding environment

PHARMAC must always consider the impact of its decisions on all New Zealanders. While it is understandable that there is sometimes very vocal support for funding one particular treatment, the impacts on others must also be taken into account. Every decision to fund a medicine means another may not be funded, irrespective of how big the budget is. In that context, all New Zealanders have an interest in good decisions being made that lead to the best health outcomes. These tensions exist despite all parties, in the widest sense, wanting to improve people’s health through the best use of medicines. Where incentives and goals are not fully aligned, there is likely to be disagreement between PHARMAC and its stakeholders. This is a feature of the operating environment that cannot fundamentally be changed. Such disagreements, however, need not get in the way of fully understanding each other’s views and working effectively together; something PHARMAC is strongly focussed on.

Ministry of Health

We work closely with the Ministry, which acts on behalf of the Minister in monitoring PHARMAC’s performance. In addition to general engagement with the Ministry on a range of issues (including policy issues), we have close working relationships with two of the Ministry’s business units, Sector Services and Medsafe.

---

PHARMAC Information sheet

Sector Services (formerly HealthPAC)

Sector Services is the Ministry of Health’s claims processing unit, responsible for paying pharmacists for subsidised medicines. Sector Services also processes Special Authority applications. Information about Special Authorities is available from our Targeting Medicines Information Sheet. Sector Services can be contacted via the Ministry of Health’s website: http://www.moh.govt.nz/healthpac.

Medical groups

Professional associations for doctors, pharmacists, nurses and other health professionals provide an important perspective on medicine funding issues. We regularly meet with medical groups and seek their input through our consultation processes. We also work alongside some medical groups in developing our Access and Optimal Use activities.

Medsafe

Medsafe decides which pharmaceuticals are safe and effective for New Zealanders to use (often called ‘medicines regulation’). We usually consider a medicine for subsidy only after it has been approved by Medsafe (but there can be good reasons for departing from usual practice). Medsafe’s web address is: http://www. medsafe.govt.nz/.

Pharmacists

Pharmacists dispense prescriptions and advise patients on how and when to use the prescribed medicine. As with prescribers, we rely on feedback from pharmacists on the practicality of Schedule changes.

CARM

The Centre for Adverse Reactions Monitoring (CARM) in Dunedin is New Zealand’s national monitoring centre for adverse reactions. It collects and evaluates reports of adverse reactions to medicines, vaccines, herbal products and dietary supplements from health professionals in New Zealand, and provides reports to Medsafe. CARM’s web address is: http://carm.otago.ac.nz.

Consumer and patient groups

The decisions PHARMAC makes impact on virtually all New Zealanders, so it is important that the impact of those decisions on patients and consumers is well thought-through. We are in regular contact with patient and consumer groups and welcome dialogue on medicine funding, or other issues. In addition to direct contact with consumer groups, we also seek a consumer perspective through our Consumer Advisory Committee.

Pharmaceutical companies

We rely on pharmaceutical companies to provide medicines for New Zealanders. In most cases, when we fund a medicine we agree a supply contract with the company. In addition to supplying medicines, pharmaceutical companies are required to provide information on how a medicine works, its interactions and side effects. This information is available through Medsafe.

Clinicians and other prescribers

Clinicians, specialists, and nurses (as well as other prescribers) are the health professionals who put the Pharmaceutical Schedule into practice, referencing it regularly to determine the appropriate medicines and prescription for their patients. The Schedule tells them what is available, what level of subsidy a particular medicine has, what formulation a medicine is available in, how much can be prescribed at one time and what, if any, restrictions are in place for that medicine.

PHARMAC is the Government agency that decides, on behalf of District Health Boards (DHBs), which medicines get subsidised so that they are more affordable for New Zealanders and available nationally. The subsidies PHARMAC sets are funded from a fixed budget that is part of DHB funding. PHARMAC also promotes the optimal use of medicines, carries out some procurement for DHBs, and manages special access programmes for some medicines. Information Sheets on various PHARMAC topics are available from our website: www.pharmac.govt.nz/patients/infosheets If you have specific areas of interest (such as consultations, committees or vacancies), visit our website and subscribe to news feeds in the area(s) of interest to you: http://pharmac.govt.nz/feeds

Contacting Us

Call us on 0800 66 00 50 (between 9am and 5pm, Monday to Friday), or on 04 460 4990 (between 8am and 5.30pm, Monday to Friday). Write to us at: PHARMAC, PO Box 10 254, Wellington – we respond to all letters Email us at enquiries@pharmac.govt.nz – we respond to all emails