Act wants an independent review of Pharmac with leader David Seymour saying there are too many "heart-breaking cases" of people denied the medication they need.
It also wants to cut the number of health boards from 20 to six to "cut the bureaucracy in our health system and put people first".
"New Zealanders deserve to have world-class healthcare," Seymour said.
"People in this country shouldn't be languishing on waiting lists or living with chronic pain and illness.
"To cut the wasteful spending and put people back at the centre of the system, we reduce the number of DHBs from 20 to six, with four in the North Island and two in the South Island.
"This will save approximately $50m per year in overhead costs which can be put towards patient care."
The party of one, that is now polling high enough to attract up to eight MPs, made the announcement in its health policy released today.
The cuts to DHBs goes further than recommended in a major health sector review, conducted by former Prime Minister Helen Clark's chief-of-staff Heather Simpson, which called for the 20 DHBs to be slashed to between 8-12 within five years.
Seymour also targeted Pharmac, the drug-buying agency set up over 27 years ago, saying it needs to change to keep up with the times.
An independent review - conducted by a skilled, independent committee that includes public and private sector expertise - would allow for greater transparency and more timeliness in decision making, Seymour said.
"The decisions made by Pharmac can mean life or death.
"Having access to the right medicines can make the difference in someone's quality of life, whether they experience chronic pain or whether they're able to work.
"We have to get this right."
The Pharmac model and operating framework was set up 27 years ago, and there had been no material changes since then, he said.
"Pharmac has played an important role in managing and restraining government spending on medicines, particularly in bulk buying mass-use drugs and staying within budget.
"But the world of medicines has changed, and a rapid flow of highly sophisticated, costly, new generation medicines is transforming patient outcomes.
"In many cases, the taxpayer could actually save money by keeping people in work or saving on other healthcare interventions if more pharmaceuticals were funded. However, the current funding model doesn't consider these possibilities, it only funds a medicine if it is more effective than other ones within a given budget.
"A review should be conducted by a skilled, independent committee that includes public and private sector expertise.
"As an electorate MP, I have dealt with too many heart-breaking cases where constituents have battled to get the medicines they need to survive or live without pain. This review will ensure more New Zealanders can live the best lives possible."
Labour has promised an additional $200m funding for Pharmac over four years, while National has pledged $200m over four years for a dedicated cancer drug fund and $20 million over the same period for a new rare disorder fund.
Act will also implement a national IT platform for healthcare procurement and the supply chain, and have greater collaboration between public and private hospitals to reduce costs and waitlists.
"Ministry of Health statistics show a backlog for elective surgery of 350,000 patients. A third of those are considered of mid-level urgency.
"These aren't just numbers, they're real people who are experiencing pain and discomfort. This can impact on a person's ability to work and go about their daily lives."
Act would publicly subsidise more common elective surgeries in private hospitals through competitive tender.
This would utilise spare private hospital operating capacity, reduce public waitlists and free up public hospital operating theatres for urgent and major surgeries.
"Amidst the current global pandemic, it's more clear than ever that New Zealanders need access to good quality healthcare and mental healthcare so they can lead long and healthy lives. Act will deliver this as affordably as possible."
• Provide subsidies for private hospital elective surgery
• Improve primary healthcare in rural New Zealand
• Better integration of primary, secondary and community healthcare
• Create a national fully integrated IT platform
• Provide provision and leaseback of public hospitals
• Create a publicly funded mental health corporation, Mental Health and Addictions NZ
• Carry out an independent review of Pharmac