Towards a national medicines strategy

Associate Health Minister Peter Dunne today outlined how a national medicines strategy will be developed, resulting in a strategic look at the role of medicines in health care delivery.

Mr Dunne is leading the project, which results from the confidence and supply agreement signed between United Future and Labour after the last election.

"The long-term medicines strategy will aim to identify improvements in New Zealand's medicines processes.

The three areas of focus are:

• access to medicines
• quality of medicines and
• the rational use of medicines.

"At the moment, the debate on what medicines we use is focussed on the role of PHARMAC. How decisions are made about which medicines will be funded is very important and that's an issue I want looked at.

"But the medicines strategy is not a review of Pharmac, it is a considered assessment of the system as a whole."

Mr Dunne emphasized there will be a wide consultation process involving consumer groups, the health and pharmaceuticals industries and Government departments.

The Ministry of Health will analyse the current New Zealand system and international trends, resulting in a draft strategy document that will:

• describe the current system,
• summarise trends and their potential impact,
• propose objectives and
• address specific issues, such as how decisions are made to prioritise medicines; accessing innovative medicines including those that are high-cost; the pharmaceutical budget and
• the interface between funding decisions and clinical decision-making.

The strategy document will be submitted to Cabinet by November this year before it is released for public consultation.

Background: Long-term Medicines Strategy terms of reference

Aim
The long-term medicines strategy aims to identify where improvements can be made within the existing system and broad policy settings to ensure the best health and disability support outcomes from medicines over the coming years. In doing so, the strategy will focus on the three areas recognised internationally as the key planks for obtaining the greatest benefits from the use of medicines: access to medicines, quality of medicines and the rational use of medicines.

Context
New Zealand has established processes to support access, quality, and rational use of medicines and policy work has been undertaken recently, or is under way, in a number of key areas that will have a bearing on the development of the strategy. The strategy is aiming to identify areas for improvement that build on New Zealand’s existing infrastructure and recent policy developments.

Medsafe and Pharmac are the entities with the central responsibility for quality and access matters in New Zealand. The rational use of medicines is not the responsibility of a single agency; individual consumers, health professionals, district health boards, primary health organisations, and registration authorities in addition to Medsafe, Pharmac and the Ministry of Health all have a role to play.

Recent policy developments that have a bearing on the development of the strategy, include, The Biotechnology Strategy, the proposed establishment of the Australia New Zealand Therapeutic Products Authority, and the DHBNZ Safe and Quality Use of Medicines National Strategy. Work is also under way on matters such as direct-to-consumer advertising of prescription medicines.

Process and content
The strategy will draw on work by the World Health Organization and other countries.

The strategy’s development will begin with an analysis of the current New Zealand system and international trends. The analysis will be informed, among other things, by government and sector stakeholders, including consumer groups.

The analysis will then lead to the development of a draft strategy document for submission, by November 2006, to Ministers and Cabinet prior to formal consultation.

It is expected that the draft strategy document will:

• describe the current system
• summarise trends and their potential impact
• propose a set of high level objectives
• address a number of more specific issues.

The issues that have been identified to be examined at this stage are focussed on access to medicines and include: how prioritisation / rationing decisions are made, access to new / innovative / high-cost medicines (especially for niche groups e.g. rare diseases), and pharmaceutical budgets (e.g. Pharmac’s budget is part of DHB budgets, and the strategy could examine how the budget is set, its adequacy, and whether it should be separate or continue to be part of DHB budgets).

As the strategy progresses, other specific matters for further work may be identified.

Timeframe