Inpharmation December 2015
There’s been a significant change in PHARMAC’s impact across the health sector, as evidenced in our Annual Report for 2014/15. As well as our management of community medicines, vaccines and hospital cancer medicines, PHARMAC now has a strong influence on spending on medical supplies used in hospitals.
The biggest change over the past year came in PHARMAC’s management of hospital medical devices. From small beginnings, PHARMAC now has about 14,000 hospital medical device line items under national contracts, far outstripping the number of medicines on the Schedule.
Savings so far have been modest – up to $13 million over five years – but that is set to change as PHARMAC moves to promote competition among medical device suppliers, starting in wound care.
PHARMAC continued to manage the CPB on budget at $795 million. We also added 25 new medicines to the Schedule (21 CPB, 4 hospital) and provided increased funded access to a further 27 (20 CPB and 7 hospital).
Significant new investments during the year included:
- Abiraterone – a new treatment for advanced prostate cancer. Estimated full-year investment of $14.9 million before rebates.
- Azacitidine – to treat the blood disorders known as myelodysplastic syndromes. Estimated full-year spending of $13 million before rebates.
- Fingolimod and natalizumab – two new-generation treatments for multiple sclerosis. PHARMAC also changed the access criteria for multiple sclerosis treatments, so they can be given earlier in the disease. Estimated full-year spend of $15.6 million before rebates.
- Lenalidomide – for the blood disorder multiple myeloma. Estimated $5.8 million of gross spending in first full year.
- Nilotinib – further treatment for chronic myeloid leukaemia. Full-year spend of $2.2 million before rebates.
- Varicella vaccine – for immune compromised people and some household contacts.
- Rotavirus vaccine – to protect children from the debilitating gastric virus rotavirus. Estimated full-year gross cost of $5.6 million.
We’re continuing to make progress in obtaining benefits for District Health Boards from national contracting for hospital medical devices.
Our work has focussed on securing national contracts in six main categories of hospital medical devices. The categories we have negotiated contracts are wound care products, sutures, disposable laparoscopic devices, interventional cardiology, orthopaedic implants (trauma, spine and cranio-maxillofacial implants), and sterile wraps and associated consumables.
Our aims in managing hospital medical devices are to create national consistency in access, improve transparency of decision-making and improve the cost-effectiveness of spending to generate savings for re-investment into health.
The Pharmaceutical Schedule now lists around 14,000 line items across 16 contracts. The contracts cover approximately $43 - 47 million of expenditure, with savings to DHBs estimated at $13.2 million over 5 years.
In wound care we have begun moving to the next stage which is to actively introduce competition through a commercial process. We have been pleased with the number and substance of responses from suppliers to our Request for Proposals (RFP) on a discrete range of wound care products.
A further RFP for sterile wrap products was issued in October.
PHARMAC staff have also been meeting with DHB staff and others in hospital medical devices forums in October and November. We have been pleased that DHB staff have taken the opportunity to meet with us at these forums to share views and information about hospital medical devices work.
Earlier in the year we gave stakeholders the opportunity to tell us how we’re doing, what it’s like to work with us and what we can do better, through a stakeholder survey.
The findings from that survey are now available.
What did our stakeholders say?
Overall, our stakeholders told us that we have made major improvements since 2007, the last time we asked for feedback. During that time PHARMAC has hosted national and community forums, substantially upgraded our website, made enhancements to our consultation and notification information, implemented the application tracker and initiated a comprehensive staff competencies programme.
On the PHARMAC website you can view a summary of the stakeholder survey findings which have been broken down by stakeholder group.
The next step for PHARMAC is to consider how the feedback will shape how we do things in the future. We want to make sure that anything we do to address the feedback makes a positive difference for how stakeholders interact with us. This work is currently underway.
Thank you to those who took the time to complete the survey. If you didn’t and would like to provide feedback to PHARMAC, email email@example.com.
PHARMAC has released the preliminary results of an analysis looking at health gains from cancer medicines funded in Australia and New Zealand.
Interest in New Zealand’s access to cancer medicines prompted PHARMAC to commission the research, which assesses potential health gains achievable from cancer medicines currently funded in Australia but not in New Zealand.
The analysis used data from international clinical trials, sourced from Australian medicine data sheets and medical journal articles. The analysis then looked at how benefits measured up against a position statement on clinically meaningful benefits of cancer medicines, developed by the American Society of Clinical Oncology.
The analysis found most of the additional medicines funded in Australia but not in New Zealand do not offer health gains that would be considered clinically meaningful by international cancer specialists in recent research. Some of the medicines offer poorer health outcomes than the established NZ funded standard of care.
Few of the cancer medicines funded in Australia but not in NZ offer clinically meaningful gains for patients. PHARMAC has received funding applications for many (but not all) of these medicines, and they are undergoing assessment and consideration for funding alongside treatments for other conditions.
We found that New Zealand funded 101 cancer medicines, and Australia funded 110.
This included 88 cancer medicines that New Zealand and Australia both funded. We also found that both countries funded cancer medicines that the other didn’t: Australia funded 22 medicines that weren’t funded in NZ, and NZ funded 13 medicines that weren’t funded in Australia.
Our work on funding medicines for rare disorders is continuing. We’re trialling a new approach to funding medicines for rare disorders, to see whether promoting competition can help us provide better access to medicines for people with rare disorders.
To date we have agreed to list the first medicine assessed through this process – icatibant (Firazyr), which treats the rare blood disorder hereditary angioedema (HAE). HAE causes episodic attacks of swelling that can be life-threatening.
We’ve also reached a provisional agreement to fund sodium phenylbutyrate (Pheburane) granules, a treatment for the metabolic disorders known as urea cycle disorders, which can lead to a fatal build-up of nitrogen and ammonia in the body.
PHARMAC identified up to $25 million over five years that would be available for rare disorders medicines funding.
We’re continuing negotiations with several other suppliers as a result of the rare disorders funding process, which produced 28 proposals for 25 medicines for rare disorders.
We understand that when medicine supply issues occur these can be challenging to manage. Stock issues are often international problems with New Zealand making up only a small fraction of the global supply. However, our contracting mechanisms allow PHARMAC to work closely with the supplier to resolve any supply issues as quickly as possible. More information about our approach to managing medicine supply.
Nevertheless, we realise that short supply and out of stock issues can be very frustrating and we appreciate your efforts in communicating with patients and managing their medicine supply at such times. Thank you for your ongoing support.
Last updated: 25 January 2019