Dunne Peter: Questions for Oral Answer — Questions to Ministers 
Dunne Peter: Questions for Oral Answer — Questions to Ministers 
[Volume:624;Page:19638] 
6.  
Hon PETER DUNNE (Leader—United Future) 
 to the  
Minister of Health 
: Is she satisfied that Pharmac’s current approach to subsidising pharmaceuticals gives adequate weight to future savings in health and welfare expenditure; if so why? 
Hon ANNETTE KING (Minister of Health) 
: 
 Yes Pharmac is careful to ensure that any cost offsets in health are taken into consideration when it makes funding decisions. 
Hon Peter Dunne 
: How does the Minister reconcile that answer with the fact that research shows that for every dollar spent on pharmaceuticals $3.85 is saved on other surgical and medical procedures and also with the comments made by the chief executive of Pharmac that: “Pharmac must remember that every dollar spent on pharmaceuticals is potentially a dollar that cannot be spent elsewhere in the health sector.”? 
Hon ANNETTE KING 
: There are and can be cost savings from pharmaceuticals. Health costs can include hospitalisation surgery or entry into nursing homes. However not all funding decisions result in savings elsewhere and sometimes those savings can take years before they take effect. For example we now fund quite a large number of New Zealanders with statins which reduce cholesterol. But at this point in time we continue to need a large number of heart operations. In the future we may well get those benefits; they are not captured at this point. 
Steve Chadwick 
: Is the Minister aware of any example of costs being offset in the health sector by Pharmac’s funding decisions? 
Hon ANNETTE KING 
: Yes. Pharmac began funding Tiotropium for chronic obstructive pulmonary disease from February 2005—an investment of $33 million over 5 years. About 40 percent of this cost will be offset by an expected reduction in people admitted to hospital with respiratory problems. We have not achieved that saving yet but it is expected. 
Barbara Stewart 
: Does she consider it satisfactory that Pharmac’s monopoly on drug purchasing results in doctors’ treatment decisions being dependent upon Pharmac approval—for example the use of TNF inhibitors for rheumatoid arthritis? 
Hon ANNETTE KING 
: Doctors have the right to prescribe any medicine that has been approved by the regulator Medsafe. Usually they will try to prescribe a medicine that has a full subsidy or a partial subsidy but they are not restricted in what they can prescribe. 
Sue Kedgley 
: Why is it that despite high numbers of adverse reactions to pharmaceuticals this Government has not made it compulsory for consumer information on possible adverse reactions to be provided with all medicines nor has it followed Australia’s example and funded pharmacists to review medicines being taken by high users to check for possible adverse reactions and to recommend necessary changes? 
Hon ANNETTE KING 
: When prescribing doctors are very aware of adverse reactions and I would be very surprised if most doctors when prescribing do not advise their patient of those adverse reactions. In fact if there are adverse reactions we have a centre for adverse reactions to medicine which monitors the side effects of drugs reported not only by prescribers and pharmacists but also by patients. 
Hon Peter Dunne 
: Why does the Minister remain so satisfied with Pharmac’s performance when it is borne in mind that in the developed world only Portugal and Japan have less access to new medicines than New Zealand? 
Hon ANNETTE KING 
: We can always do better but I think the member would be most concerned if the cost of pharmaceuticals was to spiral out of control and we were unable to provide many of the other procedures and health services that New Zealanders want. I find it interesting that we now have countries like Belgium the United States and Canada looking very carefully at what New Zealand does in pharmaceuticals because they are finding it very difficult to be able to pay for them. 
Hon Peter Dunne 
: Would the establishment of a national medicines policy that seeks to ensure appropriate balances between pharmaceutical policy curative care and other surgical and medical procedures be one of the ways in which we could do better; if so why has she so far refused to do any work on implementing such a policy in New Zealand? 
Hon ANNETTE KING 
: I agree with the member that there is a need to do work on the long-term sustainability of health funding which includes pharmaceuticals. Certainly the Prime Minister announced such work in December and she is supported very strongly by the Minister of Finance and the health Ministers. But it would be unfair to say that we do not have a pharmaceutical framework in New Zealand. It is made up of first of all Medsafe which regulates our pharmaceuticals then Pharmac which manages the funding through an evidence-based assessment the Centre for Adverse Reactions Monitoring to best-practice advocacy advice and now a 3-year funding path. The only thing missing in what we do if it is compared with Australia is that we do not include direct Government funding to the pharmaceutical industry. 
Hon Peter Dunne 
: Does the Minister not recall her answers to questions for written answer Nos 12899 12910 12911 and 12912 last year—in September of last year in fact—in which she stated that she had not agreed to the development of a national medicines policy that she had received no advice on the desirability of a national medicines policy that she had not received any advice from her department and that she had set aside no funding for the development of a national medicines policy; and if she does not recall those answers how does she reconcile the answers she has given in the House today with those answers already on the public record? 
Hon ANNETTE KING 
: I certainly recall those answers. The member talked about a national medicine policy; I talked about the Government looking at long-term sustainable funding for health. That could include medicines so it is not a matter of just the single issue that that member is pursuing but of the whole sector.