Kerre Woodham: The Pharmac funding boost was the best solution

They promised they would. They said it would happen. I have to say it happened far sooner than I expected. Yesterday's post-Cabinet press conference saw Christopher Luxon, Shane Reti et al. announcing up to 26 new cancer treatments, alongside 28 other medicines to be funded as part of the government's $604 million health budget to honour National’s pre-election promise. The promise was made good on with knobs on. Some of the drugs will be available from October/November of this year. Others will be phased in as of next year and it is fantastic news.  

I don't want to be a Debbie Downer, but it will be too late for some families. And as medical oncologist Chris Jackson, cancer expert extraordinaire, said on the Mike Hosking Breakfast this morning, having the drugs available and funded is all very well and good but we need to ensure our infrastructure can deliver them.  

“We've never had any investment of this extent in the entirety of Pharmac’s history. I mean $600 million is a very, very, very big number and we have never had this many cancer drugs funded at once at any time. So despite the way we got here, I'm absolutely and utterly thrilled. There are still quite a few fishhooks though. You know, when you dump 26 cancer medicines into the system at once, the largest ever, you do create a bit of a capacity demand issue, and the cancer services are already pretty tight and there's a number of services around the country which have already got waiting lists in place. And so if we don't fund the infrastructure for them, the chemo units, the nurses and the like, then you can end up with cancer waiting lists in six to 12 months time. So we've got to be careful about how we do this.” 

Absolutely. I couldn't agree more. It is interesting how the coalition government resolved the issue of how they would get the cancer drugs to the New Zealanders they'd promised them to. They could either direct Pharmac to buy the drugs, and that's a whole can of worms. David Seymour, whose Pharmac’s Minister and National’s coalition partner was very reluctant to interfere with the decisions of Pharmac. He said as much on this show a couple of weeks ago. So he didn't want that kind of interference, ‘You must buy those drugs with this money’, and rightly so I think.  

Or you could set up a separate cancer drug buying agency that would have taken time and bureaucracy and faff. So, in the end the government had to fork out a whole lot more than they originally promised because Pharmac has a list of priority drugs it wants to fund, it only has so much money, and it must buy the drugs that will bring the greatest good to the most amount of people. Ultimately, there are other ways of doing it, but there are other considerations, but primarily that's what it must do. Look for the best deal on the best drugs that will deliver to the most amount of people. So they have a priority list, and some of those cancer drugs were in that priority list, but they were behind other drugs that weren’t for cancer. So Pharmac said all right, fine, we'll buy the drugs, but you have to give us the money that will allow us to get to their place on the list, if you see what I mean. To get to all the cancer drugs they promised they had to buy a whole lot of other drugs. So that means about 28 medicines that were not for cancer will now also be funded because they were ahead of those cancer drugs on the priority list. I think even though it's expensive, that is the right thing to do. You cannot, cannot, cannot politicise the Pharmac buying priority list, you just can't. As Chris Jackson said to Mike Hosking this morning, Pharmac may not be perfect, but it is the best option.  

“The last thing you want is pollies picking drugs. You certainly don't want Big Pharma getting large blank checks from the state, and you don't want those who tell the biggest story through the media to queue jump. What we've had here is by lifting up Pharmac’s budget, you've had, cancer hasn't queue jumped all the other medications. There’s been 26 drugs, 50 total so other areas have benefited too. It's cost them an awful lot of money because of the political problem they've created. It would have been cheaper to do it another way, but I'm really, really pleased how we've landed.  We need to make sure the implementation's done well now, because if it's not, we're going to create another problem, just down the line.” 

Yeah, absolutely. And that's what he was saying. All very well and good to get the drugs but you need to have the infrastructure so they can get to the people who need them. So I would love to hear from you on this one. Is this the best solution? I think it is. It is expensive, of course it's expensive. But you can't prioritise drugs just because you've got somebody fashionable and trendy who it can promote their drug over others. They get more media attention than others. There are less sexy diseases, less sexy drugs that don't get the attention, but the people who have the disease need it. The people who have the affliction need that particular drug, and why should they be further down the list simply because they can't get the right noise behind lobbying? It's got to be independent. It's got to be free of government interference and if it means that more people will have their drugs funded, well so well and good. There are a lot of these people who need the drugs have not brought this upon themselves. You know, it's just a roll of the dice. It is fate. That means they end up with a life-changing or life-threatening disease or illness that a drug can alleviate. They can't afford that drug, they die. They can't afford that drug. They live a life of perpetual misery. Surely this has got to be good news. 

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