Key Points:

Indicators of worsening heart health among New Zealand patients have been linked by researchers abroad to cuts in spending on cardiovascular drugs.

The connection is reported in the Canadian Journal of Cardiology by two Canadian researchers. One works for a pharmaceutical company and the other is a former industry consultant.

Their country is debating whether to introduce the controversial, hard-nosed pricing policies that have been applied in New Zealand for 14 years by state drug-buying agency Pharmac.

The study says Pharmac's "extreme fiscal restraint" has led to markedly fewer new drugs being made available for sale in New Zealand than in some other countries - 28 between 1994 and 1998, compared with 43 in Canada.

"Although only circumstantial, our results suggest an association between decreasing cardiovascular drug sales and markers of declining cardiovascular health in New Zealand," write Dr Jacques LeLorier and Dr Nigel Rawson.

Their study of New Zealand, Australia and Canada cites a range of Organisation for Economic Co-operation and Development data, but not all of the OECD's New Zealand figures clearly support their case.

They show acute heart attack mortality improving from 1994 to 2000. On the negative side, hospital discharge rates were far higher in 2003 than in 1994 for that condition; and markedly higher for circulatory diseases.

Cardiovascular system drug sales per capita fell from US$20 to US$12 ($25.22 to $15.13) from 1994 to 2004.

But Pharmac medical director Dr Peter Moodie yesterday rejected the Canadian researchers' analysis.

"The argument that because our spending is less therefore health is getting worse is silly, because our volume of these drugs has gone up, not down." Spending had gone down, "because we get better prices than other countries".

But Auckland cardiologist Dr Chris Ellis said that despite an increase in the amount of cardiovascular drugs available, Pharmac policies often unduly restricted access to the appropriate heart drugs.

Professor Harvey White, director of coronary care at Auckland City Hospital, said Pharmac was puffing out a "smokescreen".

"Our mortality rate is higher than it should be, probably as a result of Pharmac's policies, and they should address that. It's 31 per cent higher than Canada's [in 2000]. That's an extraordinary figure."

He said the researchers' results "should be a wake-up call for the Government and for Pharmac".