Describing ‘big pharma’ companies as “the forces of evil” at Health Central’s ChalkTalks held this week in Wellington, Ian Powell said that Pharmac is operating not in a level playing field but in an international market, in at an – at times – uneven and vicious environment.
“Pharmac’s model and approach has been sound and robust. You will be confronted with fairly sophisticated spin – and some of it does capture the hearts and minds of people who are desperate and in need of treatment, but you need a degree of cohesiveness.”
It must be evidence based, pointed out Mr Powell, who is executive director of the Association of Salaried Medical Specialists.
“To retain some independence, one thing we don’t do is allow possible future trade agreements to impose on the functioning of Pharmac.
“Had the Trans-Pacific Partnership agreement gone ahead at that time, Pharmac wouldn’t have been negotiating with one hand behind it’s back, but with two hands behind its back – and the pharma companies interfering and getting internal insights into its decision-making processes and getting a commercial edge.
“There need to be firm boundaries in future trade agreements,” Mr Powell said.
John Tamihere, a director of Māori health provider Hapai te Hauora, pointed out that New Zealand could get some protection in future trade agreements from an exclusion Treaty of Waitangi clause.
“It provides significant leverage for First Nations people from all around the world. It’s never been applied because it’s been seen as a native thing, as opposed to an all-of-New-Zealand treaty issue.
“The day you can make an exception to the rule in those trading agreements by using that exception is the day that you start to break the rule. I think New Zealand should start thinking about that,” he said.
Pharmac CEO Sarah Fitt said that decisions about which medicines and medical devices to fund are based on strong evidence.
“When we get an application in, we’ll get that expert clinical advice. We have a wide network of clinicians who work on our committees and that really helps us judge where this new therapy will sit in the wider health sector; what are the other options and how does it compare to what’s currently available.
“Then we do an economic analysis as a lot of these new technologies are very expensive. There’s often expensive testing that goes with the new medicine and that has to be factored into our analysis and then we have to look at all the things waiting to be funded and figure out what’s going to deliver the best health outcomes for the population,” she said.
Dr Janice Wilson from the Health Quality & Safety Commission said that New Zealand is very lucky to have an agency like Pharmac, which has a rigorous advisory and economic approach to look at what is best for the country and what is affordable.