As a result of the review of Pharmac out today, the Government is about to change something quite fundamental about Pharmac.
Up till now, Pharmac has tried to get the best health outcomes from available funding which essentially means trying to help as many Kiwis as possible with the limited money it has.
So, let’s say it had $100 to spend on cancer treatment. Up till now what it would do is buy cancer drugs for let’s say 100 of us.
But now, its criteria is being changed.
And it has to consider whether it’s doing enough to help "priority" populations, being Māori, Pacifica and disabled communities.
So, instead of helping 100 of us, it now might have to spend that $100 on helping, say, only 5 of us.
Which means this actually increases the number of us who miss out on drugs.
The example that’s used is that Pharmac funds Keytruda for melanoma but not lung cancer.
Māori don’t get melanoma as much but they do get more lung cancer, so Pharmac should fund it for lung cancer.
I'm not going to argue against funding lung cancer treatment.
But what I am going to point out is that that decision is not without consequences.
The money has to come from somewhere.
Which means some other drug which helps a greater number of people will now not be funded for that number of people.
I'm not sure that in the long run, we will consider this wise.
Because that means more people will go without drugs, which may in fact end up costing us more. Because people who don’t get drugs either fund them themselves or end up sick or dying, which means in hospital or palliative care.
Pharmac only has so much money to spend. Surely the smartest thing is to spend it on as many Kiwis as possible. Surely the smartest thing to do is to reduce the number of people who miss out. Why would we change that?
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