Advisory committee terms of reference review

What we’re doing

We're pleased to announce we have new terms of reference for Pharmac’s: 

We released a discussion document about proposed changes to our advisory committees in December 2020. 

The feedback we received was supportive of the major proposed changes, and we are pleased to announce that we will be progressing them. The four main changes to our advisory committees will be:

  1. Broadening the role of the CAC to allow them to be involved in all areas of our work, including the potential for medicine funding proposals
  2. Renaming Subcommittees of PTAC as Specialist Advisory Committees with their own terms of reference
  3. Increasing consumer input into our clinical advisory committees, including the potential to have a consumer member on PTAC and on Specialist Advisory Committees
  4. Enhancing health equity expertise and diversity on our advisory committees. 

The new terms of reference will be in place from 1 November 2021. Some of the changes to the terms of reference will take a bit of time to implement. We are working with our advisors over the coming months to implement the changes. 

What you told us

We’re grateful for the time people took to provide thoughtful responses about the proposed changes.

We received feedback from 23 respondents. There are some further changes that we have made to the terms of reference based on the feedback received:

  • We have allowed for consumer representation on our Specialist Advisory Committees, as well as PTAC (our proposal only considered consumer representation on PTAC). 
  • There were a range of suggestions for administrative changes to meeting management and recruitment processes for our clinical advisory committees. To make the terms of reference documents more concise, much of this administrative detail has been moved into a Member Handbook. This means these supporting aspects of how the committees run, as opposed to what the committees do, can be updated as needed without further consultation on the terms of reference themselves. We had already done this with the CAC terms of reference before we sought feedback on them. 
  • We have strengthened the section on te Tiriti o Waitangi in the PTAC and Specialist Advisory Committee terms of reference to align it with the section already in the CAC terms of reference. 

How we plan to implement these changes

Broadening the role of the CAC

The purpose of the CAC has been broadened to “The CAC advises Pharmac on strategic, policy and operational activities in the remit of Pharmac that have an impact on consumers”. Previously the CAC was excluded from having a role in pharmaceutical funding decisions. 

We have already begun to seek advice from the CAC about some of our planned pharmaceutical procurement. 

We do not anticipate that the CAC will be involved in all the pharmaceutical funding decisions that Pharmac makes. We want to make sure that how and when we seek advice from the CAC about funding decisions does not add extra administrative burden and provides meaningful additional advice into our decisions. 

Separate terms of reference for Specialist Advisory Committees

Having separate terms of reference for the Specialist Advisory Committees makes it clear these committees have different, but complementary, roles, expertise and perspectives to PTAC.   

PTAC provides and promotes critical appraisal of the strength and quality of evidence for funding applications. This is applied rigorously, systematically and consistently across all therapeutic groups.   

Specialist Advisory Committees provide Pharmac with specialist knowledge and expertise within specific clinical areas such as diabetes, cancer, and mental health. This includes considering the suitability aspects for the New Zealand health system.  

PTAC and Specialist Advisory Committees may make recommendations to Pharmac that differ from each other when looking at the same evidence. Pharmac considers the recommendations provided by all our clinical advisory committees when assessing applications. 

While the new terms of reference for the Specialist Advisory Committees will come into effect from 1 November 2021, there will be a transition period where committees are called both Specialist Advisory Committees and Subcommittees. Meetings that are already scheduled will continue to operate as Subcommittees of PTAC. This includes meetings that are scheduled to be held in November, as they had already been scheduled prior to the terms of reference coming into effect. 

There will also be some small name changes to some of the committees. You can find full details of the names and members of the Specialist Advisory Committees.

We won’t be going back and renaming Subcommittees in previous existing documents. This means that in the Application Tracker(external link) and our records of meetings, some will be referred to as ‘subcommittee’ and all future documentation will refer to ‘Specialist Advisory Committee’. 

Consumer input into PTAC and Specialist Advisory Committees

A wide range of different suggestions were made on ways Pharmac could consider consumer perspectives as part of our clinical advice network. Most of the feedback identified that there would need to be appropriate support for consumer members on clinical committees. 

Our first step has been working with our CAC to identify how we can have better consumer input, and potentially include representation, in our clinical advisory committees. We plan to have members of our CAC attend PTAC in an observer capacity. They will then provide advice and help identify actions we can take, to improve how consumer information and input is considered as part of PTAC meetings in the future. This advice will also help us consider ways to bring consumer information and advice into our Specialist Advisory Committees. 

We originally planned for CAC observers to attend the August 2021 PTAC meeting. Unfortunately, due to COVID-19 Level 4 restrictions, this couldn’t happen. We are now planning to have members of our CAC attend the November 2021 PTAC meeting as observers instead.

This will be the first step we take. Having the provision in the terms of reference for consumer members on PTAC and Specialist Advisory Committees will not necessarily mean a consumer member will be on all committees, and it won’t happen immediately. Making these changes will take some time.  

Any consumer members on our clinical advisory committees would be selected using standard appointment protocols and processes for those committees. We are still working out how engagement between our CAC and any consumer members of our clinical committees could work. 

Enhancing health equity expertise and diversity

CAC, PTAC and Specialist Advisory Committee terms of reference all now include a requirement for members to bring an understanding and commitment to achieving health and medicines access equity. 

When we recruit new members to our committees, we will be looking to increase diversity and equity expertise.  We are also planning to work with our clinical advisory committees to strengthen the equity capability of the membership. 

If you have any questions about these changes, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.