Recent research from The University of Auckland, published in BMJ Open, has shown that GPs are broadly satisfied with the current range of medicines available in New Zealand, but that financial barriers could be created for some patients by funding changes (such as those in the recent budget).
The aim of the study, led by Dr Zaheer Ud-Din Babar (Head of Pharmacy Practice in the School of Pharmacy) was to evaluate GPs’ perceptions regarding access to medicines in New Zealand and to identify GPs’ views about the Pharmaceutical Management Agency of New Zealand (PHARMAC), the New Zealand government agency that decides which medicines are subsidised.
This was a qualitative study, the first of its kind, involving half-hour face-to-face interviews with general practitioners.
“The pharmaceutical industry suggests that New Zealand is lagging behind regarding access to medicines, that there is a big problem, and that more drugs should be added to the system” says Dr Babar. Our research shows that GPs are generally satisfied with patients’ access to medicine, with some saying this has improved in recent years.
“However, the GPs did acknowledge that there are some drugs patients miss out on, and also that complicated administrative procedures can sometimes create barriers for them receiving subsidies for some medicines.”
Of all medicines consumed in New Zealand community settings, over 78 percent are publicly funded.
New Zealand has kept pharmaceutical costs down primarily through the policies of PHARMAC, which manages drug costs by promoting the use of generic medicines and by using a capped national budget along with a variety of contractual arrangements with pharmaceutical companies. These include “sole supply” contracts for off-patent drugs, by which large discounts are obtained in exchange for exclusivity, and “bundle” agreements where PHARMAC may list expensive new drugs in New Zealand’s Pharmaceutical Schedule (which lists all drugs for which subsides are available) in return for the manufacturer discounting the price of other products it supplies.
GPs in the study were asked their views on the pharmaceutical industry’s opinion that access to medicines is poor. Some were dismissive, citing the self-serving nature of the statement, while others reported that, while this may be an issue in relation to some medicines, it was not a widespread occurrence.
Cost, according to Dr Babar, does compromise access to medicine, and the recent change in prescription costs announced in the budget will make a difference.
“The cost of a prescription item has risen from $3 to $5”, he says. “If patients are getting five medications, which is not unusual, that’s $10 more every time they get their prescriptions filled. Some people may not be able to collect their prescriptions or choose only to collect some of them.”