It is ridiculous to get nit-picky about the massive $604 million injection into Pharmac needed for National’s delayed delivery on the cancer drugs it had promised during the campaign. The good in it far outweighs the fraught political tale of how it came to pass.
It’s great news for many cancer patients – and has ended up being good news for a fair few others as well, given Pharmac now has enough funding both for a raft of new cancer drugs (26!) and new medicines for other conditions.
Prime Minister Christopher Luxon is clearly also hoping it is also good news for his Government and National. The failure to deliver on those cancer drugs in the Budget had become a lingering nightmare for him. And if you’ve failed to deliver, you’re best to make up for it by over-delivering.
To get there, it has ended costing twice as much as National had expected at a time there isn’t much money to dispense.
A promise doubled is a problem halved: it’s a fair bet both Luxon and Finance Minister Nicola Willis think it is well worth it: in this case, throwing money at a problem is the medicine for making a headache go away.
So the government delivered on its promise and super-sized it in the process. The cancer drugs now on offer will cover more types of cancer that those on National’s initial list.
In doing so, it has effectively taken out an advance on next year’s Budget: the $603 million required is a pre-commitment from the 2025 Budget. It’s a fair chunk of the $2.4 billion the Government has set as its allowance for new spending in that Budget.
Luxon has tried to paint the expansion of the policy as government largesse, although its hand was largely forced by the Pharmac model.
The Government had looked at either directing Pharmac to use the funding for the cancer drugs or setting up a separate cancer drug buying agency. A reluctance (including from Pharmac’s minister and coalition partner David Seymour) to muck around with Pharmac’s independent and specialist decision-making model thwarted that.
So in the end, Pharmac pretty much just told the government how much money it would take to cover all the drugs on its priority list up to the point that the last of those 13 drugs (or the equivalents) would be included. That meant about 28 medicines that were not for cancer will also now be funded – and Pharmac’s list will be whittled down from about 140 to about 85.
Of the 26 cancer treatments, about seven are on National’s original list but the replacements for the rest are either similar or better. Common sense prevailed on that front after earlier indications from Health Minister Shane Reti that the list would not change, despite cancer advocates coming up with better alternatives.
In its response, the Cancer Society welcomed the funding but also put in a plea that such a situation was never repeated. It asked for a more transparent budget model and allocation for new medicines. It also asked for funding to ensure the flow-on costs were covered: paying for the nurses and specialists and equipment and hospital space needed to administer the meds.
Luxon said that would come from contingency funding (a spare pool of cash the Government puts aside to pay for surprises or unforeseen costs).
He did not say how much that would be beyond $38 million for the first year – the cheapest year while the rest of the drugs are bought in.
Having politicians hand-pick the drugs themselves while on an election campaign has proven to be a much more fraught exercise, as Luxon almost conceded.
He has chosen to try to leave all that it all in the rear-view mirror, as best intentions gone a bit awry but delivered in the end.
It will be details, details to the folk in Voter Land. Spending more money on medicines is never a bad political move.
Whether it will mean the end of politicians trying to decide which medicines should be funded remains to be seen: and Seymour pointed out there will be more medicines coming out which people will call to be funded.
However, National has learned a painful and expensive lesson about doing due diligence on election policies in this area.
At least sick New Zealanders will now get the benefit of it.
