How are we doing? Seeking GP feedback on medicines funding

Pharmac’s role is to make decisions on funded medicines from the budget given to us by the Government.

An essential part of our work is ensuring that doctors who work with and treat patients have a voice, along with others, in what we propose to fund. Pharmac staff need to make sure we have considered all the information available to us, so our decisions help you deliver the best possible health outcomes for New Zealanders.

Your feedback and insights matter to our work, and we’re always keen to hear from you.

Before we ask for feedback

We are always looking for ways to optimise the use of medicines. If we’re planning to fund new medicines, widen access to currently funded medicines, or consider other changes to existing funded medications that might impact people, we create a proposal that we consult on.

Often, you’ll see us putting out consultations when we’re proposing to:

• fund new medicines or widen access to currently funded medicines
• consider what medicines to include in our annual tender
• make changes to currently funded medicines, such as changes in brands, adjustments to eligibility criteria and changes to the rules around prescribing or dispensing.

Before we consult, we gather information related to the impact for consumers and their families, the health sector and suppliers. This includes seeking advice from our Pharmacology and Therapeutics Advisory Committee and specialist advisory committees. This informs the proposal we want to get feedback on.

Getting feedback

When we consult, we publish a proposal on our website outlining the impacts and specific information about the treatments or changes we think you will find relevant.

You can receive consultations and decision notifications related to your area of practice by signing up for the “pharmaceutical funding decisions” mailing list.

We ask for feedback from a wide range of people, including health professionals, advocacy groups and the public, to ensure our decision-making is fully informed and transparent and meets the needs of the healthcare sector and wider community.

It is important for us to hear directly from doctors who are treating patients with the health condition for which we’re looking to fund a medicine. We want to hear whether you think we have set out the right eligibility criteria, how you feel the changes should be rolled out if the funding proposal is approved, what educational resources you would find useful, or what you think the transition period for a brand change should be.

All feedback is welcome – we don’t have any expectations about the size or nature of your feedback. It could come from you as an individual doctor or from a group of doctors.

The consultation period is usually two weeks, which balances providing enough time for you to think about what we’re proposing and submit feedback and progressing the proposal as quickly as possible for people waiting for their medicines to be funded.

We have recently updated the ways in which you can provide your feedback to us. Our consultations now have links to an online form that asks you specific questions about parts of the proposal we think it would be useful to know more about. Alternatively, you can email us at consult@pharmac.govt.nz

What happens with the feedback?

Once the consultation has closed, we read and consider all the feedback. We really appreciate hearing from you, even if you don’t have any specific issues with the proposal. We are pleased to read your support of our proposals, as it indicates that our thinking is on the right track.

Where issues are raised through consultation, we consider potential changes to our proposal to address the feedback and look into things we might need to investigate further. Sometimes, we return to our advisory committees, talk further with the health sector, or adjust supplier contracts.

An example of where we made changes in response to feedback from doctors was when we proposed to fund trastuzumab for a type of gastric cancer in August 2023. Through our consultation, we heard that patients with gastro-oesophageal junction or oesophageal cancer would receive the same benefit as the group proposed for funding. After considering this feedback and seeking clinical advice, we also decided to include these other groups. This meant doctors could help more patients receive treatment.

Considering all the feedback and addressing any issues raised can take some time. The time following a consultation before a decision is made can vary. It depends on how much more work we need to do, including whether we need to seek further clinical advice or do further financial analysis before we can form our final proposal.

The final decisions on our proposals are made by our board or a senior leader under delegated authority from the board. Once a decision has been made, we let the public know and email everyone directly who responded to consultation to inform them.

When we communicate our decision on a proposal, we organise the feedback we’ve received by theme and share our response to the proposal so you can see how we have considered it.

There is a period between us notifying the public of our decision and when the changes to medicines funding take place. We aim to ensure new medicines are available as soon as possible so that you can start using them with your patients.

Your input matters

Consultation has always been a part of Pharmac’s funding processes, and it’s written into our obligations under the Pae Ora (Healthy Futures) Act 2022 and, before that, the Health and Disability Services (Safety) Act 2001.

Most importantly, we want you to know your input matters. We want to hear about your clinical experiences, or any advice or evidence we may have overlooked. We want to make sure that our decision-making is fully informed, transparent and has a positive impact on the healthcare sector and the health of the community.

For more information about our current consultations and to provide feedback, visit our consultations and decisions webpage. 

Geraldine MacGibbon is Pharmac’s director, pharmaceuticals

This article was originally published by NZ Doctor on 12 September 2024(external link)(external link) (reproduced here by permission)