Learning from our past, looking to our future
From Chief Executive Sarah Fitt
What a momentous year 2018 has been! Not only did we look back and celebrate PHARMAC’s 25 years of delivering value to New Zealanders, we also did a lot of planning to position us to ensure we continue to meet our objectives for the future.
A key part of that future focus can be seen in the look and feel of this Year in Review, which officially launches the new expression of our identity, Te Pātaka Whaioranga.
Incorporating Te Reo Māori into our name signals our commitment to Te Tiriti o Waitangi, and our updated identity shows that PHARMAC is focused on adapting to the future as we continue to build on the solid foundations of our past.
I’d like to highlight a number of other significant accomplishments and progress this year, including:
- funding more medicines for more New Zealanders
- taking on the full budget management of all hospital medicines
- our growing involvement with the management of hospital medical devices
- our focus on reducing inequities in access to medicines
- important work towards ensuring the community’s voice is reflected in what we do and how we do it.
This year, we welcomed our new PHARMAC Board Chair, Hon Steve Maharey. Steve brings a wealth of knowledge to the Board and we look forward to his guidance and oversight as we take on new challenges. We would like to acknowledge Stuart McLauchlan, who served as Chair for eight years. Stuart’s contribution to PHARMAC was immeasurable and we wish him the best for the future.
More medicines for more New Zealanders
During the year, PHARMAC continued to expand the range of funded medicines available to New Zealanders.
We funded 13 new medicines, including the shingles vaccine, Zostavax, a quadrivalent influenza vaccine for the 2018 flu season, and aflibercept for degenerative eye conditions.
We also widened access to 39 currently funded medicines, including emtricitabine with tenofovir disoproxil fumarate (Truvada) to prevent HIV infection (PrEP), zoledronic acid to the adjuvant treatment of early breast cancer in postmenopausal patients, five treatments for pulmonary arterial hypertension (PAH), and rivaroxaban, an anticoagulent used for preventing strokes and for preventing or treating blood clots.
In total, these decisions benefited an additional 331,700 New Zealanders.
In addition, we listed two more medicines for use in public hospitals, including cetuximab for head and neck cancer, and widened access to a further two.
Widening of access included removing Special Authority criteria and restrictions. This allows a greater range of prescribers to initiate treatment, and means:
- more people benefit from the medicines
- there is less administration work for health professionals.
Special Authority criteria and restrictions were removed from:
- macrogol 3350
Managing the full budget for all hospital medicines
The responsibility that the Minister of Health gave us this year to manage the funding for hospital medicines was a major expansion of our role.
As a result, PHARMAC now decides which medicines are publicly funded in New Zealand, whether they’re dispensed through community or hospital pharmacies.
A key benefit of our expanded role is that it gives us greater scope to create efficiencies in spending across all medicines subsidised by the Government.
Ultimately, this frees up more funding to reinvest in the health of New Zealanders.
Towards a new era of managing hospital medical devices
This year, we brought more hospital medical devices – which include a vast array of products that aren’t medicines but are used for diagnostic or therapeutic purposes – under national contracts.
These contracts enable all District Health Board (DHBs) to purchase products under the same terms.
This work is laying the foundations for our future role, decided by the Government, which will eventually see PHARMAC manage a nationally-consistent list of medical devices used in all DHB hospitals nationwide.
We’ll soon be engaging with DHBs and others about the next phase of our work in managing medical devices.
As well as making investments in new medicines, PHARMAC works to make savings where we can. This enables the available funding to be used to treat more people.
"Our activities, including the annual tender, resulted in full-year savings of $59 million."
This roughly equates to the cost of running a regional District Health Board for a third of the year.
In a year when we celebrated 25 years of PHARMAC, it’s interesting to reflect on the $59 million savings this year, which compare well to the saving of $3.1 million in PHARMAC’s first full year of operation.
Following the success of our contestable funding pilot, PHARMAC moved to formalise policy settings and set up a dedicated process for considering funding of medicines for rare disorders.
We published principles outlining a definition of rarity, along with the sort of medicines PHARMAC would consider when calling for funding applications from time to time.
Clinical advice on medicines for rare disorders will be sought from a new Rare Disorders Subcommittee, established in July 2018 as part of the new process.
Pharmaceutical companies responded positively to this year’s call for funding applications, with 13 applications considered at the Rare Disorders Subcommittee’s initial meeting in November 2018.
Principles: Medicines for rare disorders
- The medicine has been approved by Medsafe, or an approved international regulatory authority, for the identified indication.
- The disorder is a clinically defined disorder affecting an identifiable and measurable patient population with a prevalence of less than 1:50,000 in New Zealand.
- The medicine is only registered for the treatment of the rare disorder, or if it is registered for other disorders (or is part of phase three clinical trials for other disorders), the cumulative prevalence across all indications still meets principle 2.
Combined Pharmaceutical Budget spending for the year was on-budget at $870.8 million. This enabled 45.8 million prescription items to be funded – an all-time high.
Most New Zealanders, 3.68 million of them, received a funded prescription item during the year.
CPB investment decisions by year
|Year||New listings||Widened access||Total|
"Engagement with the wider community was a major focus of our work this year."
We went out to communities to seek their views on how we can improve the way we work with New Zealanders and involve them in our decision making.
We know that many people would like better insight into our decision-making processes, and the opportunity to have greater input into decisions.
It’s important to us as a public organisation, that PHARMAC is accessible and responsive to people’s needs, and work is already underway towards improvements based on the engagement we carried out this year.
Our anniversary celebration reinforced to us all what a huge contribution PHARMAC has made towards the health and wellbeing of New Zealanders over the past 25 years.
Improving access to emergency contraception
We also enabled pharmacists to provide emergency contraception treatments without a prescription.
This increases the number of options for people to get timely access to emergency contraception.
This is an important step that will help prevent unplanned pregnancies, as the emergency contraceptive pill is most effective when taken as soon as possible.
Helping to reduce smoking
One of the Government’s health priorities is a Smokefree New Zealand by 2025.
We made changes to the Pharmaceutical Schedule that support this priority by enabling pharmacists to provide funded nicotine replacement therapy (NRT) without a prescription.
Allowing pharmacists to independently authorise NRT gives people an additional option to access these funded products, and in some cases, reduces the number of steps to get funded NRT.
This year marked my first year as Chief Executive, and it’s been a privilege to continue PHARMAC’s strong legacy and build a strong and supportive relationship with our Board and stakeholders across the health system.
It’s exciting to be leading the organisation into the future, as it continues to grow and evolve to meet new challenges and fulfil its crucial role in our health system.
Last updated: 21 December 2018