PHARMAC to change how it makes funding decisions

Media release

PHARMAC will change the way it makes funding decisions from late next year.

Its nine Decision Criteria will be replaced by 15 Factors for Consideration.

The change will occur in late 2015 once PHARMAC is certain that people understand the new Factors and how they will be used. The changes follow an extensive public consultation process during 2013 and 2014.

Chief Executive Steffan Crausaz says the Factors, like the current Decision Criteria, will help PHARMAC when making funding decisions.

“They will help us continue to meet our legislative objective, which is to achieve the best health outcomes for people that are reasonably achievable from within the funding provided.

“We sought the views of the community, health professionals, pharmaceutical suppliers and public during this process. This was important as the way we make decisions affects nearly every New Zealander.

“Feedback through consultation helped us to understand what people want us to be thinking about in our decision-making. It also told us what we can improve in our current processes to help people understand how we make our decisions.”

“One of the major changes is the explicit acknowledgement that PHARMAC considers the impact of a decision on a person, their family, whānau and on wider society, and also recognises the wider impact on the health system.  PHARMAC will consider these impacts in terms of need, health benefits, costs and savings, and suitability.

“PHARMAC also acknowledges its commitment as a partner of Te Tiriti o Waitangi by considering the impact of a decision on Māori health need,” says Steffan Crausaz.

Other population groups facing inherent health disparity will also be considered under PHARMAC’s new framework.

“Pacific peoples and other population groups experiencing health disparity will be specifically considered, and PHARMAC will endeavour to engage further with the Pacific community to identify how we can work towards improving PHARMAC’s responsiveness.”

Steffan Crausaz says PHARMAC is announcing the change now to give people sufficient advance notice of the coming change.

“The changes are substantive. This lengthy lead-in time will enable PHARMAC to help familiarise people with the new Factors to make sure they are well understood before they come into effect. This will help to ensure a smooth transition to the new decision making framework.

“We are aware that there is significant work that needs to be undertaken before the changes can be implemented. We are working through these and will keep people informed throughout this process.”

PHARMAC reviewed its Decision Criteria as part of a wider look at its operating policies and procedures. Changes are designed to support the range of PHARMAC’s funding decisions, including medicines, vaccines and medical devices.

PHARMAC has produced supporting information that provides more detail on each of the Factors for Consideration and how PHARMAC will use these in its decision-making.