Let’s make Pharmac fit for purpose in the 21st century
Govt drug buyer must show better transparency, accountability for decisions it makes
Every year about 60,000 babies are born in New Zealand. Nearly all new parents want to see their precious bundle grow, continue to smile, do as well as they can and enjoy life. The extended family enjoys seeing glimpses of mum’s eyes, dad’s nose, grandpa’s dimple, and grandma’s smile. Everyone hopes the new addition to the family will have a lifetime of health and wellness.
But unfortunately, life isn’t that straightforward. Children fall off bikes and break legs, stay up coughing from a cold brought home from school, and can develop illnesses that require even more care. In each case, there’s a hope that someone will be there to help. There’ll be a doctor who can set a cast, another to hand out the right antibiotics, or a specialist to provide treatments you’d never needed to know the names of before.
We’d hope our loved ones were getting the best, most modern drugs to treat their illness, but we wouldn’t really know the options. Most people don’t think of healthcare until they, or their family and friends, need it, after all.
But if your child develops a chronic, lifelong illness, it can become one of the only things you can think about.
Over the summer, I visited Camp Purple. It’s a holiday programme set up for children with Crohn’s disease, which is an incurable inflammatory bowel disease. I saw children hugging their friends from last summer. I also saw children holding zip-locked bags their parents had carefully packed with all the drugs they needed to get through in one week.
The drugs currently funded by the government for Crohn’s slows the progression of the disease, but they lose effectiveness over time, and in some cases completely stop working. I spoke to the older kids and felt their fear for the future. What if the drugs stopped working for them? Would they be able to hold down a full-time job?
Last year, I met a woman called Jess who’d faced that reality. The drugs had stopped working. At 34 she’d already had over 30 surgeries, is constantly in and out of hospital, and suffers from chronic pain. It means she’s unable to work and contribute, even though she wants to.
Under our current system, nobody is asking whether it would be better financially to fund a newer drug for Crohn’s that would also allow Jess to live a more fulfilling life than to pay for a life of ongoing surgeries, hospital stays and ostomy bags. Nobody’s asking whether it would be better for her mental and physical wellbeing.
They can’t. The funding model for drugs in New Zealand doesn’t consider these possibilities or tradeoffs.
The decision on which drugs to fund is made independently by Pharmac. It’s an agency given a budget of about $1 billion each year to buy the drugs we find in pharmacies and hospitals, and the medical devices needed for our treatments. It was set up to solve a problem of a different era; politicians promising to fund new drugs and overspending on them.
Pharmac did its job to rein in spending, but the world of medicines has changed since it was set up nearly 30 years ago. Amazing advances are being made in medicines and treatments that are transforming patient outcomes.
We need to review Pharmac to make it fit for the 21st century and for modern healthcare.
There are too many heart-breaking cases of New Zealanders suffering and battling to get the drugs they need to survive or live without pain. So many of these drugs are funded in so many other countries.
There needs to be better transparency and accountability for the decisions being made by Pharmac.
Only then can we improve not just health outcomes but financial outcomes, too.
As a country, we could end up saving money on costly and traumatic surgeries and prolonged hospital stays by funding more and newer drugs. Importantly, we’d improve the wellbeing and quality of someone’s life by being able to keep people in the jobs they enjoy. We’d improve the quality of a child’s life by reducing the number of days they’d miss from school and the social isolation that comes with that.
I want to live in a country that gives every child the best chance to live the best life possible. That includes a modern healthcare system that funds the best drugs for every child’s future wellbeing.
Brooke van Velden, MP, is the deputy leader of the Act Party. This is part of a new series of columns that will be appearing each week.