PHARMAC Flashcards
What is pharmac? (4 points)
- set up in 1993
- crown entity reporting to minister of health
- board appointed by minister of health
- ~100 staff with a mix of backgrounds (medical, scientific, pharmacy, economics, policy)
What are the expanding roles of pharmac? (5 points)
- 1993-2002: originally community medicines
- 2002: hospital medicines added
- 2012: funding for hospital cancer treatments
- 2013: funding and assessment of vaccines, HML
- 2014: first national contract for hospital medical devices.
What is PHARMAC’s role in the health sector? (5 points)
- minister establishes pool of $$ spent on health
- minister decides how much will be available for vaccines, community and cancer medicines
- PHARMAC manages funding of community meds, vaccines and in hospital cancer Tx within that budget
- decides what meds can be given in DHB hospitals
- contracts nationally for hospital medical devices
What is pharmac NOT? (4 points)
- medicine supplier
- fund holder (DHBs hold the budget)
- regulator or safety agency (that’s medsafe)
- supply chain of medicines (thats Phx and pharmacy wholesalers
What are the 4 main steps in managing the medicines budget?
- budget is set annually by the minister
- forecasting: how much is committed to past decisions and how much is available?
- free up new funds to invest in new treatments
- invest funds for additional health gain
What are the 2 funding pathways in pharmac?
- pharmaceutical funding applications for the funding of new meds
- named patient pharmaceutical assessment: funding for exceptional circumstances
What are the 8 steps in funding new medicines?
- receipt of proposal
- medical advice
- economical assessment
- prioritisation for funding
- negotiation
- consultation
- implementation
Who can write in funding proposals? (3 points)
- can be initiated by anyone
- pharmac receives ~20-40 community applications per year
- all applications managed by TGMs
What happens in step 2: medical advice? (4 points)
- pharmacology and therapeutics advisory committee gives their opinions
- makes an evidence based assessment
- all 9 decision criteria considered
- makes recommendation to PHARMAC
What happens in step 3: economic assessment? (2 points)
- budget analysis: medicine cost + other cost/savings to sector e.g. DHB resoures
- Cost utility analysis:
What is the advantage of using CUA in pharmac? (3 points)
- provides info on relative value
- compares possible outcomes on diff Tx across diff conditions
- enables prioritisation across different health interventions
What happens in step4: prioritisation? (2 points)
- takes into account all decision criteria
- identifies lead candidates for funding
What happens in step 5: negotiation and contracting? (3 points)
- difficult to discuss $ and health together but if paying more than necessary, less $ is available for other meds
- aim to achieve best value per $ spent
- may lead to re-evaluation of steps 3 and 4
What happens in step 6: consultation? (2 points)
- proposal published and widely circulated
- want to ensure all relevant info considered
What happens in step 7: decision? (2 points)
- made by the PHARMAC board
- decision is informed by: 9 decision criteria, consultation responses, PTAC recommendations, views of PHARMAC staff
