Decision criteria consultation
As part of a rolling review of our operating policies and procedures (OPP), PHARMAC has reviewed our decision criteria. The outcome of this review is a new decision-making framework that will be introduced in late 2015.
Introducing the Factors for Consideration
The 15 Factors for Consideration will replace the current nine decision criteria. PHARMAC will use the Factors to help us to determine if a funding decision would help us to achieve our Statutory Objective.
More details on the new factors can be found in Changing the way we make decisions - the Factors for Consideration.
Implementation of the factors
The Factors for Consideration will come into effect late 2015. This new decision making framework is a big change for PHARMAC, and requires long lead-in time to ensure there is a smooth transition from using the Decision Criteria to using the Factors for Consideration.
We will be undertaking further engagement externally throughout 2015, prior to implementation of the Factors, to help familiarise people with them.
June and August 2013: first round of consultation
PHARMAC held our first round of consultation from June to August 2013. This consultation included a series of 12 community forums at different locations around New Zealand.
Following the first round of consultation, PHARMAC developed a proposal for change to the current decision criteria. A stakeholder event held in April 2014 also provided an opportunity for stakeholders to feed back on the proposal for change.
PHARMAC has now published a summary of submissions to reflect back what we heard in this round of consultation. We are considering these submissions and will be presenting the final decision later in the year.
If you would like further information on any stage of the consultation process, or need to ask us a question, please email us at firstname.lastname@example.org.
PHARMAC’s decision criteria
PHARMAC’s current decision criteria will remain in place until the new factors come into effect.
PHARMAC uses the criteria set out below, where applicable and giving such weight to each criterion as PHARMAC considers appropriate, when making decisions about which pharmaceuticals are available for public subsidy:
- The health needs of all eligible people;
- The particular health needs of Māori and Pacific peoples;
- The availability and suitability of existing medicines, therapeutic medical devices and related products and related things;
- The clinical benefits and risks of pharmaceuticals;
- The cost-effectiveness of meeting health needs by funding pharmaceuticals rather than using other publicly funded health & disability support services;
- The budgetary impact (in terms of the pharmaceutical budget and the Government’s overall health budget) of any changes to the Schedule;
- The direct cost to health service users;
- The Government’s priorities for health funding, as set out in any objectives notified by the Crown to PHARMAC, or in PHARMAC’s Funding Agreement, or elsewhere [Tell me more about the Government's health priorities]; and
- Such other criteria as PHARMAC thinks fit.
While the first stage of the consultation has closed, you are welcome to look at the consultation material we asked people to use to help form their views.
If you would like further information on the consultation, or need to ask us a question, please email us at email@example.com.
One of PHARMAC’s nine decision criteria (criterion eight) is “the Government’s priorities for health funding, as set out in any objectives notified by the Crown to PHARMAC, or in PHARMAC’s funding Agreement, or elsewhere”.
The Ministry of Health has advised PHARMAC to use the Ministry of Health’s Statement of Intent to identify those priorities. For the purposes of decision criterion eight, the Government priorities will be those outlined in pages 6 and 12 (health targets) of the Ministry of Health's Statement of Intent 2013 to 2016.
In addition to asking people to make submissions using our online consultation tool, we held a series of community forums to seek the community’s views face to face.
We also arranged times to meet with people who wanted to discuss their feedback with PHARMAC staff but were unable to attend a Community Forum event.
Consulting on criteria for funding medicines
The video was filmed at the first of the community forums, in Auckland, on 25 June 2013.
Last updated: 25 May 2016