An independent panel has released a scathing interim report into our national drug-buying agency Pharmac.
The review panel - chaired by former Consumer New Zealand chief executive Sue Chetwin - is looking at whether Pharmac is achieving its objectives, including how quickly it makes decisions and the transparency of that process. It’s also looking into equity at the organisation, including access to medicines for Māori, Pacific and disabled people.
Chetwin says the panel has been meeting frequently since March and has heard from people across the health spectrum. It’s received 213 submissions.
“It was concerning that almost without exception, the feedback contained many elements that were critical, particularly of the timeliness and transparency of Pharmac’s decision-making processes,” Chetwin said.
The interim report has found multiple failings, including that Pharmac “closely guards its information”, leaving the public poorly informed about the decisions it makes. The report found there is “considerable” scope to broaden the involvement of consumers in the decision-making process.
“Stakeholders observed a fortress mentality that permits little transparency and openness, increasingly disconnected from other parts of the health system” the report says.
Even the review panel struggled to access the information it needed which it says was due to gate-keeping by Pharmac
“We are not currently in a position to make meaningful comment about how well or otherwise Pharmac is performing. The reason is this: Pharmac zealously guards information about a host of operational and financial matters, making it difficult to measure the extent to which it is meeting its objectives. What information it has given us limits meaningful analysis.”
The report also found that while Pharmac has made commitments to improving equitable outcomes for Māori and Pacific people and disabled people, “it is a long way from achieving this goal”.
“Stakeholders raised concerns that Pharmac’s clinical advisory subcommittees have few Māori or Pacific people or disabled people on them. Very few of its staff are Māori,” the report read.
The panel described Pharmac’s understanding of barriers to health equity as “narrow” and there was a lack of understanding of Te Tiriti o Waitangi.
“Lack of understanding impacts Pharmac’s ability to eliminate inequities for Māori,” the report said.
Patient Voice Aotearoa spokesperson Malcolm Mulholland says the report is not surprising.
“I was wracking my brain to think when have I read such a damning report into a government agency. It seemed pretty clear to me that Pharmac is a law unto itself, they need to be reined in and reminded of what their purpose is.”
His wife Wiki Mulholland, who also spent many years campaigning for patient rights, died last week after a long battle with cancer. Mulholland says instead of feeling vindicated by the report’s findings, he feels sadness.
“There are a lot of people we’ve lost along the way, my wife being one of those people, who have said ad nauseum, especially to the politicians, you need to wake up and hear our concerns. The fact it’s taken us this long to get to this point means in the interim hundreds of thousands of patients have been missing out on medications that they so desperately need.”
In a statement, Health Minister Andrew Little said Pharmac is “the envy of the world, but it’s sensible to look at how well it is doing the job we want it to do”.
“Why the hell on the week that I’ve buried my wife does the Minister of Health come out and say that Pharmac is the envy of the world? They’re not.”
Pharmac CEO Sarah Fitt says the agency accepts many of the observations made in the Interim Report and is making changes to how it operates. She says it’s looking forward to seeing the recommendations of the review panel when they are handed over to government in February 2022.
“We want to reassure New Zealanders that we are listening,” said Fitt.