Stewart Barbara: Debate on Crown Entities Public Organisations and State Enterprises — In Committee 
Stewart Barbara: Debate on Crown Entities Public Organisations and State Enterprises — In Committee 
[Volume:646;Page:15668] 
BARBARA STEWART (NZ First) 
: 
 On behalf of New Zealand First I rise to take a call on the Pharmaceutical Management Agency. This Crown entity has a hugely important task ahead in managing the optimal purchase and use of medicine for all New Zealanders. 
This organisation has a huge challenge ahead and I do not think that any one of us can underestimate that challenge. It needs to balance its budget yet ensure that New Zealanders have the best possible access to the best medicines to manage the various conditions they have. It also has to manage the funding of expensive developing pharmaceuticals for various conditions that small groups of people have against the funding that will provide the greatest health gains for many people. It is not an easy balance. 
There are many challenges ahead. How can Pharmac ensure there is timely and affordable access to high-cost specialised medicines that is comparable with access in other countries? We often compare ourselves with Australia in this respect. 
We have seen one of these conflicts recently with the drug Herceptin where the High Court firmly put the ball back into Pharmac’s court with the advice that it had to consult over its decision not to fund patients for a longer time. How many other conflicts like this will we see? This type of court case is extremely stressful for everybody involved and we cannot afford to drag out the recommended review any longer than is absolutely necessary. 
When we look at Pharmac we see that consultation with stakeholders must be one of the priorities that is carried through. We acknowledge the recent Pharmac forum and the positive feedback that Pharmac received from the forum. This type of forum needs to be held on a very regular basis so that explanations decisions and feedback can all be communicated. The Pharmac updates that we receive as MPs always make interesting reading; they focus on recent decisions and information. We will continue to be interested in the Pharmac decision-making process particularly in response to the  
Medicines New Zealand  
strategy. We in New Zealand First believe that this should result in some review of the pharmaceutical budget. The funding framework has to allow for appropriate growth because new innovative medicines become available all the time. This of course raises the age-old issue which we have heard about many many times of the need for greater transparency in the processes associated with funding decisions. 
When people travel to Australia for holidays—as many do—one of the many queries that we all tend to get when they return is why their family member there has access to a particular drug that is not accessible to people here in New Zealand. They find it very difficult to understand. We believe that we need to be assured that the process followed by Pharmac is fair and just and the recommended consultation process will be very valuable in this respect. 
In New Zealand First we often hear too from frustrated companies that the registration of new medicines is an extremely slow process. We need to evaluate alternatives to a stand-alone Medsafe. One option that could be considered is a system based on recognition of the decisions of other respected international regulatory bodies yet at the same time allowing us to maintain the ability to carry out the evaluations where it is considered to be necessary. Why we do not already recognise these decisions remains a mystery and hopefully it can be explained by Pharmac in some future communications. Why should we duplicate the efforts of the US Food and Drug Administration or the trans-Tasman agency over in Australia? It makes one wonder what the value of particular registrations overseas is when we do not recognise them here in New Zealand. It seems to me that it is a real mystery. Recognising them would enable new medicines to go through the registration process a lot more quickly than they do now. We in New Zealand First believe that there is a very interesting year ahead for Pharmac.