Pharmac changes rules on drug access

John Forman, executive director of the New Zealand Organisation for Rare Disorders. Photo / Richard Robinson.

Patients in urgent need of unfunded drugs may soon be given their medication under a new Pharmac scheme.

Next week, Pharmac's Named Patient Pharmaceutical Assessment (NPPA) will replace the current Exceptional Circumstances scheme, which catered only for patients with rare disorders.

NPPA will enable any patient to apply for unfunded drugs, instead of waiting for the drug to be added to the official Pharmaceutical Schedule.

Cancer patients are among those likely to benefit from the change, said Cancer Society national health promotion adviser Sarah Penno.

"Most oncology drugs are quite expensive, so Pharmac negotiates those with drug companies, but some medications fall outside Pharmac, especially those of high cost or for a small number of patients," she said.

"Under this new assessment, if there is a patient who doesn't meet the normal criteria, their doctor can apply to have the patient put on it."

Pharmac acting chief executive Steffan Crausaz said the agency saw the change as an improvement based on individual need rather than rarity of a condition.

Funding would increase from the current $4 million to about $8 million over the first year, and each case would be assessed by expert clinicians.

"This means careful decisions will have to be made about which medicines are affordable," he said.

But people with rare disorders say the change will mean they will face more competition in getting funding for drugs.

NZ Organisation for Rare Disorders executive director John Forman said he acknowledged there were some benefits in the change, but not for his members.

"Essentially they are making a few improvements because there were some complications related to Exceptional Circumstances," he said.

"But they haven't done anything towards funding special medicines; in fact, it makes it more difficult."