Proposal to decline inactive funding applications

Medicines Consultation Closed

What we’re proposing

To help make our decision-making process clearer, we are seeking feedback on a proposal for PHARMAC to make decisions to decline the 97 funding applications detailed in the tables below.

These applications are inactive, meaning that PHARMAC is not currently actively undertaking any work to progress these applications for funding.

Further information about this proposal, including details of each application and how to provide feedback follows below. 

Consultation closes at 5 pm on Friday 30 July 2021 and feedback can be emailed to applicationfeedback@pharmac.govt.nz 

Why we’re proposing this

PHARMAC’s role is to decide which medicines are funded to get the best health outcomes from within a fixed budget, and we know that the decisions we make impact nearly every New Zealander. All funded medicines are listed on the Pharmaceutical Schedule(external link).

We are committed to making our decision-making process faster, and clearer and simpler for people to understand. We want to ensure that people can easily see what is happening with funding applications. This includes making it clearer what stage applications are at in our processes, and why we make our decisions.

We’ve heard from New Zealanders that they want PHARMAC to reach decisions on funding applications so they can have some certainty, even if our decision is to decline funding. 

To give people more clarity about what we may – and may not – fund, we’re looking to make decisions to decline funding for a number of inactive applications. This will make it clearer to everyone whether a medicine is, or is not, being actively considered for funding.

There are a range of reasons a funding application may be inactive, including:

  • our expert clinical advisors recommended that the funding application be declined
  • other more clinically preferred medicines for the same condition are now funded, making the funding application no longer relevant
  • the medicine would provide no additional benefits over other treatments we already fund, or may be harmful
  • no company is willing to supply the medicine in New Zealand.

Feedback from this consultation will help us make decisions on the funding applications for the medicines detailed in this consultation.

Details about our proposal

We have identified inactive funding applications for 85 different medicines that we are proposing to decline. For each of these funding applications, we have provided our rationale as to why we are considering declining the application. In the majority of cases, it is because we received advice from our clinical advisors to decline the application. Alternatively, it is because, since we received the application, we have funded a clinically alternative medicine. 

PHARMAC has not yet made a decision about these funding applications. 

Before we do, we want to hear from people and communities about whether it would be appropriate to decline funding for these medicines for the use requested. We want to ensure any final decisions are made having considered all relevant information, so we are also interested in receiving any information about the 98 medicines and indications we’re consulting on that would lead us to reconsider our proposal to decline funding for them. 

A decline decision would mean the medicine would not be funded for the use requested. However, it would not prevent PHARMAC from reconsidering funding for these medicines in the future if, for instance, new evidence or other relevant information that addresses the reasons for the decline decision became available. 

All consultation responses will be considered before making a final decision on any of these funding applications. These decisions would be made by the PHARMAC Board or its delegate using PHARMAC’s Factors for consideration.  We expect to make these decisions over the next few months, depending on the feedback we receive. 

Information about how PHARMAC decides which medicines to fund is explained on our website.  See the following links:

Common terms used when describing our funding application assessment and decision-making process are explained in the following table.

Term

What does it mean?

Application

A funding application received from a supplier, clinician, consumer or generated by PHARMAC staff.

Inactive application

Following consideration of expert clinical advice, PHARMAC is not currently actively undertaking any work to progress the medicine for funding for the use requested.

Factors for Consideration

The Factors for Consideration are the framework PHARMAC uses when making funding decisions.  The Factors are not weighted or applied rigidly, and not every factor is relevant for every funding decision PHARMAC makes. This is because the situation for one assessment may require quite different considerations compared with another. Funding decisions are made relative to other options, and the context within which decisions are made is constantly changing.

Medsafe-approved

Medsafe(external link) is responsible for the regulation of medicines and medical devices in New Zealand, ensuring they are acceptably safe.

PTAC

PHARMAC’s primary clinical advisory committee, the Pharmacology and Therapeutics Advisory Committee, is made up of senior health practitioners from a range of specialities. PTAC considers clinical evidence for funding applications and takes into account all of PHARMAC's Factors for Consideration before making recommendations to PHARMAC. PTAC’s role is to provide objective clinical advice to PHARMAC.

Subcommittee

PTAC has over 20 expert Subcommittees which provide clinical evaluations in specialist areas. PTAC subcommittees meet as required to discuss issues referred to them by PTAC or PHARMAC.

CaTSoP

Cancer Treatments Subcommittee of PTAC – the expert Subcommittee relating to cancer treatments.

Recommended for decline

A recommendation to PHARMAC from PTAC or a Subcommittee to decline the funding application.

A recommendation is not a decision by PHARMAC.

Cost neutral recommendation

A recommendation to PHARMAC from a clinical advisory committee (PTAC or a Subcommittee) to only fund a medicine if it costs the same or less than another comparable medicine (ie one that is already funded which provides the same or similar health benefits).

Proposing to decline

A proposal from PHARMAC to make a decision to decline funding for a medicine.  This is issued before a final decision is made.

Decline decision

A decision by PHARMAC (the Board or its delegate), using the Factors for Consideration, to decline funding for a medicine.

PHARMAC decides which medicines will be funded, comparing all the options, to ensure we are getting the best possible health outcomes for New Zealander from a fixed budget set by the Minister of Health.

Applications that we are proposing to decline

In the table below you can find information on each of the applications that we are proposing to decline. For ease of navigation, the applications have been categorised by therapeutic group. The reason why we are proposing that the application is declined can be found in the 3rd column in the table (the column is titled “Why we are proposing this application be declined”).

In a number of cases, we are proposing that the application be declined as we received advice from our expert clinical advisors that we should decline the application. In these cases, further information on why our advisors recommended decline can be found by following these steps:

  1. Click on the ‘here’ hyperlink within the relevant Clinical advice summary column OR click on the hyperlink in the Applicant and brand name column. This will take you to the appropriate page on PHARMAC’s Application Tracker.
  2. Once on the Application Tracker, click on the pharmaceutical name and indication. This opens up the application page.
  3. Click on the words ‘Seeking Clinical Advice’. This will open a list of the meetings in date sequence at which the application was considered by our clinical advisors.
  4. Meeting records (record) from each of the meetings can be accessed by clicking on the text underneath the word ‘Links’.
  5. To find the relevant section within the records either scroll through or use ‘ctrl and F’ to open the search function and search using the medicine name or the indication.

Please note that if you don’t want to click on the hyperlinks in the table below that you can search for the pharmaceutical directly from the main Application Tracker(external link) on the PHARMAC website and then select the correct indication. 

Applications that we are proposing to decline

Alimentary and metabolism

Pharmaceutical and indication

Applicant and brand name (if relevant/ specified)

Why we are proposing this application be declined

Additional information

Benefibre - Fibre supplement for constipation

Clinician application(external link)

The Nephrology Subcommittee of PTAC recommended this application be declined at its meeting in December 2014 [PDF, 86 KB]

Please click here(external link) for further information. Click on the Pharmaceutical name, and when the Application opens select ‘Seeking Clinical Advice’ tab. The record detailing the clinical advice can be found under ‘Links’.

Calcium phosphate oral rinse for oral mucositis following chemotherapy or radiation therapy