PHARMAC 2020/21 Quarter 2 Performance Report

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PHARMAC is halfway through the first year of delivery of our new strategic direction and despite the challenge of an ambitious work programme we are doing well achieving our goals.

5 of the 6 strategic priorities are on track, and performance has been good with most measures and work activity on track. However, some pockets of work have taken longer to deliver than anticipated as new considerations are brought to light through engagement and review points. This has led to a few initiatives being delayed but overall, we are confident that with a concerted effort we can get these initiatives back on track. 

To ensure we lift our organisational excellence, we need to address our capability gaps and better resource our supporting strategies (Te Whaioranga and People and Capability). During the quarter we have developed a clear view on our resourcing needs and are focused on addressing these as quickly as possible so we can start to see real momentum, particularly in upholding our Te Tiriti obligations.

We achieved some significant milestones over the second quarter. These included:

Priority: Equitable Access and Use

Milestone: Re-establishing our Responsible Use Advisory Group with new members and mandate, to support PHARMAC’s strong focus on medicines access equity.

Milestone: Producing insights on medicine use for the arthritis condition Gout and what equity gaps exist for Māori and Pacific Peoples.

Priority: Relationship & Partnerships

Milestone: Releasing a stakeholder engagement survey to better understand the needs of our partners and their perceptions of PHARMAC.

Priority: Te Whaioranga

Milestone: Completing an initial review of PHARMAC’s policies, practices, systems, and processes to ensure they align and reflect Te Tiriti.

Priority: Public Understanding, Trust and Confidence

Milestone: Releasing draft terms of reference for our primary advisory committees (PTAC and CAC) for public feedback to help PHARMAC better incorporate consumer voices into our decision-making.

Note: PTAC stands for Pharmacology and Therapeutics Advisory Committee. CAC stands for Consumer Advisory Committee.

The impact of COVID-19 is still affecting aspects of our core business, but even so we are still managing to successfully balance this along with our core medicines assessment and decision-making work and with delivery of our strategic initiatives. As PHARMAC works through the delivery of our strategic direction over the next four years, we also require improvements to our core systems. Management is keeping a watching brief on progress to improve our processes and systems to ensure they are fit-for-purpose and keep pace with the needs of our future business. 

Over the next quarter we are looking forward to:

  • Undertaking work to better understand public preferences for pharmaceutical spending.
  • Supporting the health sector as we work together to build the IT infrastructure required to achieve wide-scale procurement savings for DHBs in medical devices (FPIM or Finance, Procurement, and Information Management System).
  • Beginning engagement with the health sector on fairer access to medical devices.
  • Working with the PHARMAC Board and Senior Leadership Team to develop their Te Tiriti o Waitangi accountabilities.

Priority: Enhance key functions

We continuously improve the way we work to deliver maximum value to New Zealanders.

A key focus for this programme over the last quarter has been to identify resource needs and bring additional support on board. Most aspects of this programme are tracking well and as long as we continue to secure the resourcing needed for the workstreams coming online in Q3 and Q4, then we are on track to meet our milestones.

During the last quarter PHARMAC has been planning for public engagement to better understand public preferences for pharmaceutical spending (a key milestone for this year).

Focus over the coming quarter:

  • Engagement with the public to better understand public preferences for pharmaceutical spending.
  • Shaping up a programme of work to improve planning and implementation practices for our commercial activities.
  • Starting work on an Emergency Management Plan to support PHARMAC’s operational response to support the health sector in a civil defence or public health emergency.
  • Gathering data on PHARMAC’s efficiency across key processes core to our daily operations. The first of these measures became available this quarter for our Time to Rank Applications.

Overall Progress:

Green: On track

Priority: Equitable access and use

We enable equitable access to medicines and related products by influencing availability, accessibility, acceptability, and appropriateness.

The majority of initiatives within this programme are tracking well however it has been given an Amber rating as a significant part of this programme (the Outcomes Framework) will require a concerted effort over the next six months to ensure success. Next steps involve further iteration of the methodology and our focus will be on ensuring the output is robust, is valuable for DHBs and influences change. A detailed plan is currently being put together on how we will achieve this.

Some key achievements over the last quarter in this programme were engaging with the Health Quality & Safety Commission and Arthritis New Zealand to strengthen our partnerships and progress a MoU, and appointing advisors for the newly reconfigured Responsible Use Advisory Group (first meeting held on 2 December 2020).

Focus over the coming quarter:

  • Undertake a cultural capability needs assessment with our clinical advisory network and identify potential gaps.
  • Continue the implementation of our medicine access equity monitoring and outcomes framework, ensuring a plan is in place to mitigate the challenges associated with the next phase of this work.

Pacific Responsiveness Strategy

Due to staff vacancies last quarter, we had not made as much progress initiating Stage 2 of the Strategy as we had intended for the first half of 2020/21. This work is now back on track with resourcing issues resolved. Our focus for the rest of the year is to continue detailed planning of the programme for Stage 2 and start implementation.

Overall Progress:

Amber: Issues identified but under management

Priority: Medical devices

We drive better value and more consistent access to hospital medical devices.

Overall progress is on track for this programme of work although preparing for focussed engagement has taken longer than we had originally anticipated. We are still on track to begin sector engagement on fairer access to medical devices during the second half of 2020/21.

A significant achievement to date is reaching $330 million under agreement with another $75 million in progress (our target is $400 million of DHB spend under national contract by end of 2020/21). We have also identified members for a new DHB Strategic Medical Devices Advisory Group and should have this running by the end of Q3.

Focus over the coming quarter:

  • External engagement on fairer access to medical devices (engagement to begin in Q3/Q4).
  • Completion of the market share activity report (focused on wound care).

Overall Progress:

Green: On track

Priority: Data and analytics

We measure health outcomes and make evidence-informed decisions, using and making available data and insights from a wide range of sources.

Last quarter this programme was rated Amber due to our increased emphasis on Data and Analytics, particularly in health outcome measurement. Workstreams have been bought forward and additional resource secured to increase our pace of delivery. We are now on track to achieve against these new targets.

Our most important progress has occurred in the area of developing a methodology to measure health outcomes.  During the quarter, we engaged external consultants (Sapere) to provide advice on the scope, approach, and resourcing for progressing this work, and the Senior Leadership Team approved a pathway forward for this work.  Securing additional resource to support this work also commenced during the quarter.

Other key achievements over Q2 involved moving into Phase 3 of the Combined Pharmaceutical Budget Forecast Refresh project which sees us bring onboard additional data sets to our system and streamline existing processes. The visual analytics tool Qlik, implemented in 2019/20, is now in wider use with goo