Associate Health Minister David Seymour speaks about Pharmac and myeloma blood cancer drugs. Video / NZ Herald
Associate Health Minister David Seymour has big plans for Pharmac, including a scheme to boost its funding, and possible cost-share arrangements, whereby it would split the cost of a drug with patients.
In a wide-ranging interview, the Act leader also discusses why NZ spends comparatively little on medicines, thehuman cost of that approach, and his view on Pharmac chief executive Sarah Fitt.
David Seymour, the minister responsible for Pharmac, wants to allow the drug-buying agency to secure more money by showing how funding medicines would save the government money overall, such as by keeping patients in work and out of hospital.
That major reform should happen this term, said Seymour, the Associate Health Minister. He expects it could, over time, greatly boost New Zealand’s spending on medicines.
Currently, NZ spends less than a third of what other countries spend on medicines, after accounting for population size and GDP.
That is the case for multiple myeloma medicines, for example. No new drugs for the common blood cancer have been funded for a decade, and patients miss out on proven medicines that would keep them alive and healthy for years longer.
“It’s an incredible story of what people are prepared to do. On the other hand, it’s not the kind of story you want to see in New Zealand.
“As the person responsible in government, I’d love to march down to Pharmac and tell them to just fund the poor guy’s drugs.
“But I also know the minute I do that I’ve blown up the whole model [in which politicians have no say over funding decisions], and it would be unfair on a bunch of other people whose conditions could actually be just as bad or worse.”
It was essential to guard against politicians influencing Pharmac decisions, Seymour said.
However, he wants to change some of the rules Pharmac has to work by.
The agency was established in 1993 when government finances were dire, he said, and had been “very successful” getting bang for limited buck, including in negotiations with drug companies.
“However, I think there are other questions like, ‘can we actually get better value for New Zealand as a whole if we spend more money on pharmaceuticals?’”
As an example, a couple years ago he attended Camp Purple, an event for young people with inflammatory bowel disease, and learnt some attendees had repeated surgeries which could have been avoided with a drug, ustekinumab.
“The Government at that time would fund multiple operations, often removing much of a kid’s intestine, ultimately leading them to require a colostomy bag. And yet they wouldn’t fund the drug that could save that.”
Ustekinumab was funded in December 2022, “but I think we could have got there faster”, Seymour said.
Another example was a constituent in his Epsom electorate who had multiple sclerosis (MS), but didn’t qualify for a funded drug until her health deteriorated to the point she could no longer work.
New Zealanders' access to funded drugs lags behind most of the developed world. Photo / Jason Oxenham
How Pharmac changes could work
Seymour has asked officials to investigate ways Pharmac could make a Budget bid to the Finance Minister, detailing expected “whole of government” savings, while also keeping the minister and other politicians in the dark as to what the drug is, to protect from possible political interference.
“That’s the challenge. But that’s the challenge we’re taking on … we’ve got a few ideas.”
Robust analysis would be done on whether promised savings eventuated, and that track record would influence future bids, Seymour said.
He wants consideration of other “out of the box” changes in the system, including cost-sharing arrangements - where Pharmac or a drug company would share the cost of a drug with the patient - and enticing more clinical trials to New Zealand.
There will be no record increase for Pharmac in this year’s Budget, he said, because big increases under Labour weren’t funded into the future. “That does give us really tough choices” about spending increases, he said, but Pharmac’s budget wouldn’t drop.
Asked if he had confidence in Fitt, Seymour said he did, but such appointments were made by Pharmac’s board. A new chair would be announced soon and new members appointed by the end of the year, he said.
“I don’t want to go over the top of the board. Otherwise, why have one?”
He had visited Pharmac and found the agency made up of “tremendous, diligent, talented” people doing their best for New Zealanders with a limited budget.
“[They] have the job of saying no to people in desperate circumstances, because they know that they can do more good with the money somewhere else.
“I suspect that they get more negative feedback from the people whose drugs they can’t fund, than thanks from the people [receiving drugs] they do decide to fund.
