Our context

There are several important factors that together describe an exciting and challenging context for our work ahead. With any change, there is also ambiguity and uncertainty. Managing change requires a balance of assuredness in our direction – which this final response provides – with flexibility and agility in the specific details and timing of future work.

Staff wellbeing

Our staff are our biggest asset. We must provide a working environment that is inclusive for all people and supports staff wellbeing. This includes providing the resources necessary to deliver on additional roles and new expectations of our work. 

Health reforms

We are focused on supporting the reforms’ early success, including the implementation of the interim Government Policy Statement on Health and the interim New Zealand Health Plan. The reforms provide clear direction with respect to pursuing health equity, and improved integration will need additional effort by all involved. The progress and detail of the Therapeutic Products Bill is also important to our work, especially
in hospital medical devices.

Te Tiriti o Waitangi

Pharmac will rightly be judged by Māori for how effective we are in giving effect to Te Tiriti, including building partnerships and contributing to improved health outcomes. Te Tiriti also embodies equity for Māori as tangata whenua and for all people as tangata Tiriti.

Budget uplift

The recent Budget 2022 uplift to the Combined Pharmaceutical Budget, an increase of $191 million over two years, will result in many new medicines being funded, along with wider access to existing medicines. Several exciting investments have already been announced, with more to come. Delivery will require continued focus and effort from within existing resource.

Increasing expectations

Notwithstanding the recent budget uplift, there will always be strong advocacy for funding of new medicines, and more options than we can possibly fund. Some new medicines are also expensive and have incomplete or emerging evidence about their effectiveness. Our role is to make careful decisions, well-informed by evidence and all relevant information, about the best funding choices for New Zealand.

Appropriation

The Combined Pharmaceutical Budget is now directly managed by Pharmac via a Vote Health Appropriation.1 This is a significant change from the previous 20 District Health Board arrangements. The Appropriation enables Pharmac to have a medium-term investment pathway, with potential over time to improve timing and phasing of funding decisions.

(2022/23 Vote Health estimates of appropriation’s name is the ‘National Pharmaceutical Purchasing
Appropriation')

Hospital medical devices

As recognised in the Government response, management of hospital medical devices is a strong fit with our capability. We have made significant progress since commencing this responsibility in 2012, including cataloguing and standardising contractual terms for thousands of devices to enable better management and savings of over $100 million. With the Government supporting our continued lead, we are progressing our work in close collaboration with Te Whatu Ora and other key agencies and stakeholders.

Pacific peoples and priority populations

Alongside Māori, Pae Ora directs a stronger focus on health equity for priority populations, including Pacific and disabled people. This directly underpins our equity priority discussed in section 10. This requires strong contributions from multiple agencies, including connection to overarching frameworks like the All-of-Government Pacific Wellbeing Strategy (and related work like the Pacific Wellbeing Outcomes Framework) and New Zealand Disability Strategy. These connections are also important to recognise and address multiple disadvantages that some people experience within priority populations.

Rare disorders

The health and disability system needs to do more to improve the lives of people with rare disorders. There is scope for a range of agencies and stakeholders – within and outside the health and disability system – to work more effectively together. We are looking forward to supporting Manatū Hauora in its important work to develop a rare disorders strategy.