Enhancing assessment and decision-making

9.1 The opportunity

We want to further enhance the quality of our assessment and decision-making for medicines, vaccines, and hospital medical devices. We can build on our strengths, including our evidence-based decision-making.

While there are many aspects to resetting our assessment and decision-making processes, embodying te Tiriti o Waitangi and equity considerations are particularly important, as is incorporating diverse perspectives across our work.

9.2 Titiro whakamua – the path ahead

Since 2018, we have been working on increasing transparency and making our funding assessment and decision-making processes faster, clearer, and simpler, while retaining the robustness of our decisions. We have made good progress, with further improvements to come. Our future work will include:

• bringing more diverse voices into our assessment and decision-making
• resetting our medicines, vaccines, and hospital medical devices assessment framework
• ensuring our processes for making applications are more user friendly
• tailoring our assessment and decision-making processes to make better use of our resources
• publishing information about our assessments and decisions that meets people’s needs.

9.2.1 Bring more diverse voices into our assessment and decision-making

Drawing on a diversity of viewpoints is central to ensuring we make quality decisions. It can also give people confidence in the robustness of our decisions. We see potential for a more inclusive and connected approach to how we undertake assessments and make decisions. Our future work will include:

• securing input from a more diverse range of stakeholders earlier in our assessment and decision-making, including clinical experts and those with lived experience
• better understanding, through both research and engaging with consumers, what people value when making difficult choices about what to fund
• collaborating with Te Whatu Ora and Te Aka Whai Ora to ensure our processes reflect health and disability system priorities, and that other parts of the system are ready to support and implement our decisions.

9.2.2 Reset our medicines, vaccines, and hospital medical devices assessment framework

Over time, we will reset our assessment framework by:

• reviewing our assessment methods to embed equity considerations
• updating our assessment methods and decision-making processes to ensure they give effect to te Tiriti o Waitangi and more deeply consider impacts across different groups of people
• revising the Factors for Consideration to ensure we consider all of the factors people consider are important when making our decisions
• responding as needed to strategies developed as part of Pae Ora and more broadly, including a rare disorders strategy.

9.2.3 Tailor our assessment and decision-making processes to make better use of our resources

To improve timeliness and enhance our decision-making, our future work will include:

• better tailoring our expert advice processes and health technology assessments
• continuing to work towards clearing the backlog of assessments and further embedding an ongoing process to close funding applications that are unlikely to be approved
• upgrading information technology systems to automate some processes, including those used to manage the Pharmaceutical Schedule, procurement and contracts systems, and supplier and other stakeholder relationships.

9.2.4 Publish information about our assessments and decisions that meet people’s needs

We will build greater trust and confidence in the decisions we make by:

• publishing plain language summaries of assessments ranked on our Options for Investment list
• improving our web-based Application Tracker so the public can:
• access more information about our assessments
• do their own comparisons between treatments and products (for example sort options by different factors).

9.2.5 Get started on our path – our 2022/23 commitments

For 2022/23, our specific commitments to move forward on this priority are:

1. make effective use of the funding uplift provided in Budget 2022 to fund both more treatments and widen access to already funded treatments

2. commence COVID-19 vaccine purchasing and management

3. continue to secure COVID-19 treatments

4. progress two process improvement projects to improve how we (i) conduct initial assessments of funding applications to improve timeliness; and (ii) improve processes for seeking and receiving expert advice

5. explore how we present our advisory committee meeting records using our decision-making framework (the Factors for Consideration) to make it clearer how the Factors have been applied

6. clarify information published about our exceptional circumstances framework around its application to people with rare disorders, and publish better information about the outcomes from our exceptional circumstances decisions

7. prioritise engagement with our Rare Disorders Specialist Advisory Committee and proactively seek new funding applications from suppliers of medicines for rare disorders

8. explore with Te Whatu Ora, Te Aka Whai Ora, and Manatū Hauora the best way for sector views to be taken into account in our assessment of funding applications

9. continue to improve the usability of our web-based Application Tracker to support improved transparency.