Inpharmation - April 2014
In this issue:
PHARMAC’s expanded role is placing higher expectations on us
To help meet these expectations PHARMAC has been changing with a new management structure, some new faces on our Senior Leadership Team (see below), and looking at the process we use to make funding decisions.
As with any change process, the challenge has been to keep what has made us successful, while adapting to take on our expanded role. Internally our changes still mean there’s a strong focus on the assessment of medicines and medical devices. And recognising that making decisions is only half the job, our Engagement and Implementation directorate supports our decisions with information and engagement work to help patients and health professionals adapt to changes from our decisions.
The work on our decision-making process also has an eye on our expanded role. We’re currently asking for the community’s views on a draft decision-making framework (see below), and inviting stakeholders to a consultation event in Wellington on 15 April for further discussion. This framework will be used to inform our decisions on pharmaceuticals, vaccines and medical devices. So we need to hear whether people think it is fit for this wider use.
Steffan Crausaz – Chief Executive
Steffan has been PHARMAC’s Chief Executive since 2012, and before that had a senior role as Manager of Funding and Procurement, leading PHARMAC’s commercial and health technology assessment activities. Originally from the UK, Steffan trained as a pharmacist and has worked in the pharmaceutical industry (branded and generic) while undertaking his Masters in pharmacoeconomics and pharmaceutical policy.
Sarah Fitt - Director of Operations
Sarah joined PHARMAC in 2013, having spent 12 years as Chief Pharmacist at Auckland DHB. As Director of Operations, Sarah oversees the team that manages medicines and medical devices procurement and PHARMAC’s funding process.
Jude Urlich – Director of Engagement and Implementation
Jude has worked extensively in communications and social marketing, and held functional leadership roles in the public service, tertiary education and wider state sector. Jude has qualifications in public policy and has been a media spokesperson for national organisations for more than 20 years. She joined PHARMAC in 2010.
Mark Woodard – Director of Corporate Services
Mark joined PHARMAC in 2014, to lead our new Corporate Services directorate. Mark’s career has included time as CEO of Presbyterian Support and he has also been CFO for various organisations including in the health sector. He has an MBA from Wharton and a BA from Cornell University in the United States.
Dr John Wyeth – Medical Director
John joined PHARMAC in 2012 as a deputy medical director with particular responsibility for secondary care, leading PHARMAC’s clinical interactions around hospital medicines and hospital medical devices. He was appointed Medical Director in 2013, and leads the team that provides clinical input to PHARMAC, including through the Pharmacology and Therapeutics Advisory Committee. The team interacts with clinicians across both the primary and secondary care sectors.
John is a specialist gastroenterologist, a Clinical Senior Lecturer for the Wellington School of Medicine and has previously been Clinical Leader for GI Services at Capital Coast DHB.
PHARMAC is asking for people’s views on a proposed new framework for making pharmaceutical funding decisions. The proposed new decision-making framework is the result of a broad consultation held last year, in which PHARMAC asked for the community’s views on what PHARMAC should think about when making decisions.
PHARMAC is seeking written submissions and also holding a consultation event for stakeholders on 15 April to provide input. The event is a half-day meeting in Wellington – to register, go to https://www.pharmac.govt.nz/about/operating-policies-and-procedures/decision-criteria-consultation.
The proposed framework would replace the nine criteria currently in use, and would apply to all PHARMAC’s future decision-making in relation to hospital medicines, vaccines and eventually hospital medical devices.
Consultation on the draft decision-making framework closes at Easter.
PHARMAC has negotiated its first national contracts for hospital medical devices – an important milestone as PHARMAC moves to apply its model to management of medical devices.
From 1 March, as a result of contracts with two suppliers, 890 wound care products and 135 disposable laparoscopic trocars and associated instruments (used in surgical procedures) have been listed on the Schedule.
DHBs can take up these national contracts if they want to – they offer savings over current prices.
PHARMAC is continuing negotiations with a range of suppliers of other products and hopes to list further items over the coming months.
PHARMAC is changing the funded brand of tacrolimus, an immunosuppressant mainly used to prevent organ transplant rejection.
1300 patients using funded tacrolimus will change to the new brand, except for a very small number of patients who have had an intestinal transplant.
The new supplier is Sandoz, the generic pharmaceuticals division of Novartis, which is one of the world’s leading pharmaceutical companies.
Careful monitoring of patient progress will be conducted by transplant clinical teams. PHARMAC is working with transplant services to make sure transplant coordinators, clinicians and patients have the information they need.
Because tacrolimus is a narrow therapeutic index drug, it is important that, once patients change to the new brand, they are not inadvertently changed back. For this reason, PHARMAC is recommending tacrolimus is prescribed by brand.
Eltrombopag – Beginning 1 January 2014, PHARMAC is funding eltrombopag (Revolade) for the rare and potentially fatal blood disorder idiopathic thrombocytopenic purpura (ITP). Without treatment, people with ITP are at risk of severe bleeding.
PHARMAC estimates that about 40 patients will receive funded eltrombopag per year at a cost, before confidential rebates, of $36,000 per patient per year. This makes it one of the more expensive treatments to be listed on the Pharmaceutical Schedule.
Erlotinib – PHARMAC has extended funding for erlotinib (Tarceva), to be a first line treatment for a particular type of lung cancer. The funding access rules, which mean that people can now receive erlotinib as their first treatment for lung cancer, changed from 1 January 2014.
Erlotinib and another similar drug gefitinib (Iressa) are tyrosine kinase inhibitors (TKIs) that have changed the way aggressive lung cancer is treated, and improved the prospects of people diagnosed with lung cancer – still the leading cause of cancer deaths in New Zealand.
TKIs are particularly effective for patients with lung cancer that harbour a particular genetic sequence. Patients are identified using a diagnostic test called epidermal growth factor receptor (EGFR) testing. For people with this type of disease, targetted TKIs offer more effective, less toxic, and more convenient treatment.
Asthma inhalers – PHARMAC has widened access to commonly used asthma inhalers supplied by GlaxoSmithKline. PHARMAC removed the Special Authority criteria from Seretide, used by 74,000 New Zealanders with chronic asthma, which means anyone whose doctor thinks they need it can have it funded.
The agreement with GlaxoSmithKline, which includes the asthma inhalers and other products, will produce savings greater than $20 million over five years.
For more information on PHARMAC’s activity, go to https://www.pharmac.govt.nz/news/notifications.
Last updated: 22 August 2019