Te Aka Mātauranga Matepukupuku – the University of Auckland’s Centre for Cancer Research held a seminar and panel discussion on why Aotearoa New Zealand does not fund modern medicines.

Dr Rodger Tiedemann, an Associate Professor in Cancer Research and Consultant Hematologist, gave a talk debunking myths about the reasons why Aotearoa New Zealand does not fund modern medicines.

The Myths

1. New Zealand is too poor to afford modern medicines
2. New Zealand has too much debt to afford modern medicines
3. NZ’s access to modern medicines is actually comparable to other countries
4. The missing medicines are not particularly effective
5. New Zealand’s spending on medicines is similar to other comparable countries
6. New Zealand’s spending on healthcare must be pretty bad
7. NZ’s outlier ultra-low spending on medicines reflects Pharmac’s great negotiating skills
8. Either: Medicines are approved in other countries but not funded; Or: out-of-pocket expenses are much higher in other countries
9. NZ Government’s spending on medicines is on track to catch up with other countries
10. Medicines are the cause of our national debt
11. The medicines problem in NZ is too big to be fixed.

He made comparisons with other countries which demonstrated that Aotearoa New Zealand falls well short of the standard of care offered to cancer patients globally. Dr Tiedemann explained that this is due to the government’s low levels of investment in cancer treatments. While New Zealand’s health system appears to be funded in general to a level that is in line with our GDP per capita, when benchmarked against other similar countries there is a specific underfunding of pharmacological treatments. This has caused a bottleneck in the healthcare pathway in New Zealand, in which the final step of the pathway – treatment with modern medicines – is often the limiting constraint in medical outcomes. Dr Tiedemann provided evidence from the World Bank and OECD database refuting explanations that New Zealand is too poor, or too indebted, to afford modern medicines. In fact, New Zealand’s GDP per capita and General Governmental Debt compare favourably with many nations that have significantly greater access to modern medicines than New Zealand.

The underfunding of modern medicines in New Zealand has implications for scientific research and also exacerbates inequalities. Because internationally-recognised standard-of-care treatments are often not available in Aotearoa New Zealand, and because Kiwi patients have not been exposed to these – a pre-requisite for clinical trial involvement – many global clinical trials bypass Aotearoa New Zealand. Thereby limiting New Zealand patients’ access to novel investigational therapies. In addition, the lack of access to modern medicines means that patients and their whānau often actively seek treatment overseas, which can be costly. This trend to travel overseas for treatment, or to self-fund it locally, exacerbates inequalities as it is an option only for those who can afford it.

Dr Tiedemann proposed that the government initially increase Pharmac’s budget by one third, $0.5billion, which would fund most of the medications that Pharmac has already favourably reviewed and placed on the Options for Investment list. Pharmac data suggests this would potentially benefit 228,000 patients.

The panel was made up of Paula Lorgelly, Professor in Health Economics; Tim Edmonds, Leukaemia & Blood Cancer NZ CEO; George Laking, Associate Professor and Medical Oncologist, Hei Āhuru Mowai and Te Aka Mātauranga Matepukupuku; Fay Sowerby, Breast Cancer Cure chair and consumer advocate, Malcom Mulholland, Patient Voice Aotearoa, and Rodger Tiedemann.

The panel discussed patients’ perspectives and highlighted the difficulty of accessing modern medicines. Discussions then turned to the economics behind pharmaceutical funding in Aotearoa New Zealand, and comparisons to the decision making and funding processes in Australia and the United Kingdom. In response to an audience suggestion that New Zealand opt-out of the patent system to achieve lower medicines costs, George Laking explained that the government’s obligations to the patent system are outlined in our international trade agreements, and that circumventing the patent system would ultimately hinder the creation of novel medicines and the ability of clinicians to prescribe future medications.

Finally, the panel was asked what their solutions were as if they were the government; there was general consensus to increase the medicines budget as the coalition parties promised pre-election, but there was less consensus on how to do this: take it from the rest of the health system, increase taxes, accept (s)lower growth in government assets, or take it from other public sector budgets?

You can watch more here