Pūahoaho: Clarity around Pharmac’s priority lists

Pharmac has released  up-to-date information about its priority lists, including a list of declined medicine applications as part of its ongoing commitment to transparency.

“We want New Zealanders to know we have heard their concerns about a lack of transparency. We are committed to earning the trust and confidence of New Zealanders,” says Pharmac’s Director of Operations Lisa Williams. “As part of this, we will be proactively releasing information about medicine applications every six months, including when applications are being formally declined.”

Applications: 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
• only if cost neutral or cost saving
• recommended for decline.

As of today:

• There are active 128 applications on our options for investment list(external link), covering 85 different medicines, vaccines and related products for a range of diseases or illnesses
• When we first released the list in July 2021 there were 102 applications on the OFI list covering 71 medicines, vaccines and related products.
• 36 applications (covering 25 medicines, 10 of which were already on the OFI) have been added to the OFI list and 10 applications (covering 2 medicines) have been removed since we first released the OFI list in July 2021.
• Of the 10 applications removed, 9 were from one funding decision – Adalimumab
• 18 applications have been funded[1] in the 2021/22 financial year so far – 6 are new listings and 12 are widened access to already funded medicines.

“We want to be more transparent about where applications are at in our funding process,” says Ms Williams.

“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 Williams.

Declined applications

“We have been going through the inactive funding applications on our recommended for decline(external link) list, making final decisions on which applications should be declined and closed. This is not the first time we have done this, with 308 applications having been closed over the past three years.

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 people want more certainty, even if this is a decision to decline funding,” says Ms Williams. In June 2021 Pharmac identified 97 inactive applications that it thought could be formally declined and put them out for consultation(external link), giving the pharmaceutical suppliers, health care professionals, advocacy groups and the general public an opportunity to provide any new information. 

“Consultation feedback we received showed it was appropriate to decline 84 of those 97 funding applications,” says Ms Williams. “The remaining 13 will now move to our active assessment list for consideration for funding, following new information being provided.”

Further details about each of the individual applications, including the applicant, brand name of the medicine, and details of the clinical advice we received can be found in our notification document.

“Being transparent, where we can be, is important to Pharmac,” says Ms Williams. “We can’t share commercially sensitive information, but we can tell you what we are doing and will continue to do so.”

New data will be released every six months to help build a clearer and more accessible picture of Pharmac’s operations.

[1] These do not include COVID-19 treatments which are funded through a separate fund, not from the Combined Pharmaceutical Budget.