Let's be bold - bold goal 3
Create systems that enable the best investment choices to be implemented across all PHARMAC activities
Longer-term, the ability to make the best possible investment decisions across all the different roles we have, would generate the best health outcomes for New Zealand. There are a number of analytical, process and system design issues to consider – but well worth developing to generate more value from government funding of PHARMAC’s work.
Making best choices
Michael Johnson is Director of Strategic Initiatives at PHARMAC
The decisions we make are only as good as our ability to put them into practice, which makes this bold goal very important.
Sometimes within our health system we come across barriers that can get in the way of people getting medicines, medical devices, or other health services. These can be related to funding streams, or how the different structures within the health system currently work together.
Here’s an example: Some injected medicines need to be given by a doctor, but dispensed by a pharmacist first. In some cases, this could mean the patient needing to see a doctor for a prescription, taking the prescription to a pharmacy for dispensing, then returning to the doctor to receive the injection. There might even be a service cost at the doctor’s, for receiving the injection.
We need to identify these ‘accidental barriers’ that can get in the way of people receiving funded medicines or devices.
Part of the answer lies in making better use of the skills already present in the health workforce. We’ve already begun moving in that direction. This year we worked with the Ministry of Health to enable trained pharmacists to give the funded influenza vaccine to people aged 65 and over. Another example is our decision to allow pharmacists to claim reimbursement for the medicine cost when dispensing the emergency contraceptive.
We want people to get the benefit of our decisions, which means breaking down some of the silos that exist within health. This includes things like funding streams, data availability, structures and accountability lines. This will likely mean some system changes, or innovative responses to make the system work better for patients.
If we can make progress in this goal, we’ll be enabling people to get the health gains from the medicines and medical devices intended for them.
Strategy by 2025
|VISION||Critical to the health system delivering better health for all New Zealanders|
|MISSION||Best health outcomes from New Zealand’s investment in medicines and medical devices|
|CORE COMPETENCY||The distillation of diverse information to make and implement difficult choices|
|GOALS||Eliminate inequities in access to medicines|
|Generate $1 billion of savings from medical device management to reinvest in health outcomes for New Zealanders|
|Create systems that enable the best investment choices to be implemented across all PHARMAC activities|
In order to achieve our vision and goals, we will need... (enabling strategies)
|… investment in our capability to generate better outcome information and insights||To demonstrate our impact and delivery of great health outcomes through the funding choices we make, and the equitable access that is provided, we have to be able to monitor outcomes. This is an enhancement to our core competency, and will create future opportunities to engage, inform and equip others in the health system to better deliver for patients’ needs.|
|… relentless focus on delivering reliable results, whilst avoiding undue system impacts||A health system that delivers great results for patients needs a reliable partner that earns the confidence of stakeholders and patients. “On or under budget every time” is essential to the system as a whole delivering the best outcomes for patients. We need to increase our integration with DHBs and the wider health system to understand sectoral issues and minimise adverse impacts.|
|… new approaches to delivering funding benefits to patients||The current delivery models for pharmaceutical subsidies and products will need to be adapted to ensure they deliver to the varying needs of people. Health gains and equity can only be achieved if the pathway to accessing the benefits of the PHARMAC model is smooth and tailored. Our work will be informed by Te Whaioranga (our Māori Responsiveness Strategy) and our Pacific Responsiveness Strategy|
|… redevelopment of core systems for technology assessment and implementation of decisions||Sound evidence evaluation, and the delivery of benefits through independent decisions, are essential. We will need to develop new processes and systems to replace or supplement our existing practices, in order to meet the challenges of increasing scope and a changing environment.|
Last updated: 13 December 2018