Pūahoaho: Clarity around Pharmac’s priority lists

Update

One year ago, Te Pātaka Whaioranga - Pharmac released its first Pūahoaho (clarity) Report, containing the latest information about medicines, vaccines, and related products in Pharmac’s priority lists.

Pharmac have been working on increasing transparency and making funding assessment and decision-making processes faster, clearer, and simpler, while retaining the robustness of our decisions. To date we have made good progress, with further improvements to come.

The Pūahoaho Report is released every six months to provide the public with clarity about priority lists and applications recommended for decline. This bi-annual update allows the public to easily access this information, without giving pharmaceutical companies specifics that could compromise our ability to negotiate the best prices.

We understand that people want certainty, even if this is a decision to decline funding. Being transparent, where we can be, is important to Pharmac. While we can’t share commercially sensitive information, we can tell you what we are doing and will continue to do.

Proactively releasing this information is part of our ongoing commitment to transparency. It gives New Zealanders certainty about Pharmac’s decisions around funding applications.

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 from healthcare practioners, patient advocacy groups and suppliers. Some of these are for new medicines, and some are applications to widen access to medicines that are already funded.

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) – items we would like to fund when there is budget available
  • only funded if cost neutral or cost saving
  • recommended for decline.

Current figures

As of today, there are 109 applications on our Options for Investment list for 75 different medicines, vaccines, and related products.

Since July 2021:

  • 71 applications have been added to the Options for Investment list (including 49 medicines, 14 of which were already on the list for other indications)
  • 64 applications have been removed from the Options for Investment list

In 2021/22 we made 24 funding decisions including six new medicines and widened access to a further 16, benefiting more 118,000 New Zealanders.

For 2022/23 we have made 39 new funding decisions including 18 new treatments and widened access to 21 others, so far.

Recommended for decline

When we published the Pūahoaho Report in March 2022, Pharmac had 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.

Previous decision to decline applications.

As of today, there are 98 applications on the recommended for decline list. Pharmac are considering opening a public consultation later in 2023 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.

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.