Pūahoaho: Clarity around Pharmac’s priority lists

In March 2022, Pharmac released its first Pūahoaho (clarity) Report, containing the latest information about its priority lists.

Pharmac’s ongoing Pūahoaho Report will be released every six months, to provide clarity about its priority lists and applications recommended for decline summarised for the public.

“Proactively releasing this information is part of our ongoing commitment to improving transparency. However, and perhaps more importantly, it gives New Zealanders more certainty about Pharmac’s decisions around funding applications,” says Pharmac’s Chief Executive officer Sarah Fitt. 

Application priority lists

In July 2021, Pharmac began sharing its priority lists in alphabetical order. These lists show all funding applications for medicines which have been assessed but not yet funded.

Every year Pharmac receives about 85 funding applications to consider. Some of these are for new medicines, and some are applications to widen access to already funded medicines.

The applications are usually very comprehensive with detailed clinical trial information and an initial price offer. Once assessed, applications are placed on one of three priority lists:

• options for investment (OFI)
• only funded if cost neutral or cost saving
• recommended for decline.

As of today:

• there are 125 applications on our options for investment list for 79 different medicines, vaccines, and related products.
• we have added 52 applications to the options for investment list since July 2021 (including 37 medicines, 13 of which were already on the list for other indications)

In 2021/22 we funded 6 new medicines and widened access to 16 benefiting 118,000 New Zealanders. Since 1 July 2022, 17 applications have already been funded – 3 are new medicines and 14 had access widened benefiting nearly 200,000 New Zealanders.

There are several consultations in progress now which could result in 14 more funding decisions and there are more to come. This increase in funded medicines is due to Pharmac receiving its largest budget increase ever in Budget 2022.

“It’s important that we continuously work to be more transparent about where applications are at in our funding process,” says Ms Fitt.

“Publishing the options for investment list in alphabetical order ensures there is easy access to our information for all, without giving pharmaceutical suppliers specifics that could compromise our negotiating position. We can continue to negotiate the best prices with pharmaceutical companies, while building the trust and confidence of New Zealand.”

“While there will always be more medicines that we would like to fund, we hope that, by making our priority lists easily available, New Zealanders will have more clarity about where applications are at,” says Ms Fitt.

Recommended for decline

At the time we published the last Pūahoaho Report in March 2022, Pharmac made the decision to decline 84 funding applications. There were 13 other applications which had also been recommended for decline but following consultation we kept these on our ranking lists.

“As of today, there are 95 applications on the recommended for decline list,” says Ms Fitt. “Over the next few months Pharmac will consider initiating a public consultation on declining these applications as done previously. Consultation gives pharmaceutical suppliers, health care professionals, advocacy groups and the public an opportunity to provide any new information on applications for consideration,” says Ms Fitt.

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.

“We know that people want more certainty, even if this is a decision to decline funding. Being transparent, where we can be, is important to Pharmac,” says Ms Fitt. “We can’t share commercially sensitive information, but we can tell you what we are doing and will continue to do so.”