Exceptional medical circumstances schemes reviewed

  • Tony Ryall
  • Peter Dunne

Health Minister Tony Ryall has announced a review of the PHARMAC-administered Exceptional Circumstances schemes, with a view to providing better access to medicines not funded through the Pharmaceutical Schedule.

The Exceptional Circumstances schemes provide access to medicines for individual people whose health needs aren't met through the usual medicines funding.

Applicants often have rare conditions, or a set of clinical circumstances that makes standard treatment unsuitable, and the medicines can be expensive.

The three schemes (community, hospital and cancer exceptional circumstances), receive more than 3000 applications each year.

Mr Ryall says "It is important that PHARMAC gets the widest-possible range of views on the access criteria and scheme processes.

"The Government is determined to see New Zealanders get better access to medicines, and I will be interested to see the feedback from consumers, as well as the health and pharmaceutical sectors."

The Associate Health Minister, Peter Dunne says, ""People will be able to comment on questions of access, such as the current community scheme's eligibility requirement that a condition must have 10 or fewer people affected in New Zealand.

"Whether arbitrary barriers such as this assist people in need is debatable, however some type of access criteria will be required."

"This review is the key recommendation of the High Cost Highly Specialised Medicines Review panel, and is part of the New Zealand Medicines Strategy."

The review document is available at: http://www.pharmac.govt.nz/ecreview