Pharmac proposes to give more clarity about funding decisions

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Pharmac proposes to give more clarity about funding decisions

Pharmac
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An overhaul of PHARMAC’s decision-making process will give better insight into what medicines are - and are not - being actively considered for funding, Chief Executive, Sarah Fitt says.

Up until now there have been a number of funding applications that are unlikely to be funded but have remained open in the application system, so PHARMAC is proposing to decline them.

“We have open applications for medicines with little or no evidence that they work better than other medicines, with proof that they could cause people harm, or with no company able to supply the medicine in New Zealand,” says Ms Fitt.

“Unfortunately, we’ll never be able to fund everything, and we can’t justify using taxpayers’ money to fund medicines that aren’t better than treatments we already fund. We’ve heard from New Zealanders that they want PHARMAC to make definitive decisions on funding applications, so they can have some certainty, even if this is a decision to decline funding,” says Ms Fitt.

Ms Fitt says this change is just one of many that PHARMAC is making to increase transparency around decision making and reduce the time medicines spend on the “waiting list”. Other changes include updating PHARMAC’s online application tracker to make it easier to see what stage funding applications are at, and publishing summaries of our clinical expert’s advice and recommendations faster.

“We’re working hard to make our decision-making processes clearer, faster and simpler.”

PHARMAC has chosen the first group of medicines to progress to a decision and wants to hear from those interested about whether it would be appropriate to decline these eight treatments

No decision will be made until PHARMAC has considered all feedback. If any are declined, it would not stop PHARMAC reconsidering funding for the treatment in the future if, for instance, new evidence became available.

“In the future, we’ll be consulting on more proposals to decline other inactive funding applications”, says Ms Fitt.

“Feedback from this consultation will help us make decisions on the eight medicines and it will also help us determine if our consultation approach works for people who are interested in and want to contribute to our decision-making”.

For more information about this proposal, visit PHARMAC’s website: https://www.pharmac.govt.nz/news/consultation-2019-04-30-inactive-applications

Funding applications PHARMAC is proposing to decline

  • Cisapride for gastrointestinal motility disorders
  • Melatonin for people with insomnia aged 55 and above, and for people with insomnia secondary to dementia
  • Methylphenidate for depression in terminally ill people and for people that are treatment resistant, and traumatic brain injury
  • Paracetamol sustained release tablets
  • Sibutramine for obesity
  • Simeprevir for chronic hepatitis C, genotype 1
  • Temozolomide for glioma (brain tumour)
  • Trastuzumab for HER2 positive metastatic gastric cancer

These funding applications are all inactive for one or more of the following reasons:

  • our expert clinical advisors recommended that the funding application be declined more than two years ago
  • other medicines for the same condition are now funded, making the funding application irrelevant
  • the medicine would provide no additional benefits over other treatments we already fund, or may be harmful
  • no company is able to supply the medicine in New Zealand.
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