An Auckland paediatric neurologist says Pharmac's decision to switch to a generic version of an epilepsy drug in 2019 cannot be discounted as a cause of death.
Dr Cynthia Sharpe's comments come as part of the coronial inquest, led by Chief Coroner Deborah Marshall, into the deaths of six people who had switched to the drug known as Logem.
"It is indisputable if Pharmac institutes 60 generic drug changes every year, generally selecting the cheapest available, that some of those drugs will prove not to be therapeutically equivalent," Sharpe told the coroner.
"..And in my opinion, this cannot be discounted as a root cause of death."
Pharmac's move in 2019 to stop funding all other brands was part of its drive to save $30 million over five years — money it would have put into other aspects of its work.
Its decision saw around 11,000 New Zealanders have their medication switched to the generic — a move which has seen seven deaths reported to the Centre for Adverse Reports Monitoring. Six of these are being looked at as part of the coronial inquest currently underway in Auckland.
Pharmac has previously said that it believed a switch was safe...while offering options for those in exceptional circumstances.
But today, Sharpe told the court getting an exemption often proved impossible.
"I called up Pharmac to ask if this child — who had struggled to get control from multiple other drugs...who was having seizure break through and side effects — [could get an exemption] and was told no."
She said the only other option was for the parents to pay for it out of their own pockets.
Sharpe said there was research that indicated a switch was not without risks; and it was her view that Pharmac did not make these risks clear enough.
"Pharmac, through its actions and public statements, indicated to health professionals and patients that reduced control of epilepsy as a consequence of switching would be an improbable and rare event," she said.
"I have subsequently reviewed the data...It could have been anticipated to affect many patients undergoing the switch."
In November, the families of Ricky Blackler, 24, Reuben Brown, 27, Krystal Loye, 35, Andre Maddock, 31, William Oliver, 26 and Jessica Reid, 23, gave their statements before the coroner.
The inquest was due to wrap today, but the coronor has allowed counsel for the various parties to submit additional evidence until March 19th.
A decision on further hearings will be made after that, before she makes her final finding and recommendations at a later date.