25 Oct 2016

Canadians warned not to rush towards Pharmac

From Nine To Noon, 9:08 am on 25 October 2016

Canada is considering a Pharmac-style drug-buying system as it seeks to keep drug costs down, a researcher says.

At present, the country does not have a national buying scheme and individual provinces manage medicine access, meaning a drug funded in one province may not be paid for publicly in another, said Canada-based researcher Nigel Rawson.

Blister packs containing tablets.

Photo: AFP

Dr Rawson told Nine To Noon debate has heated up again recently on whether a new system is needed, possibly like New Zealand's.

"But patients are really concerned that instead of upgrading, which they would like to do, their various provincial drug formularies, they're concerned that it'll head down to a lowest common denominator type of model."

He had studied access to new and existing drugs in the two countries and concluded it was better in Canada. His study warned Canadians 'to be careful about what they wish for ' when considering a Pharmac style drug buying system.

"I looked at drugs in a wide range of areas: anti-infective, cardiovascular, gastro, intestinal etcetera and in most of these areas Canada seemed to be doing better in most provinces than in New Zealand."  

He also looked into some recently-approved oncology drugs and some new drugs for rare diseases, "and in particularly in those areas, particularly in the oncology area, that Canada had drugs available that were not apparently on the New Zealand formulary."

Dr Rawson said he didn't look at the relative costs paid for drugs in both countries - just access.

He said the equity, fairness and equal access was behind the argument in Canada for a national pharmacare model.

"The main aim seems to be a cost containment approach.  The reason that these analysts are proposing this, and indeed some politicians, is because the drug plans' costs are ever increasing and it's one way of constraining those costs."

He said an alternative to the Pharmac model may be better for Canada.  

"I'm not sure that anybody's particularly put forward an exact model that would replace or would be [suitable] instead of the New Zealand model. But I think that that's what I'd certainly recommend, that we try to work towards a model that satisfies Canadian patients and at the same time at least contains some of the costs.

"It may not contain them as strongly as the New Zealand plan, but I fully understand that provinces are struggling to pay for many of these new, expensive drugs."

Medicines New Zealand general manager Graeme Jarvis told Nine to Noon Pharmac received a major funding boost in the May budget but the number of medicines recommended by one of its technical groups for funding are still waiting for funding approval.  He said the average waiting time for such medicines is three years.

Mr Jarvis said it came down to a lack of adequate funding for Pharmac.  "And it has been lacking funding for a number of years now.  We've certainly picked that up through doing Official Information Act requests.  So, just keeping up with the population growth, then chronic diseases etcetera.  We've got that additional funding coming in now but it's probably not enough, to be quite frank."

Pharmac said it was not surprised to see Canada examining New Zealand's model, because "we consistently obtain value from all suppliers and pass the benefits on to patients".