Access to Medicines and Pharmaceutical Policy in New Zealand: Comparing the issues with United Kingdom, Australia and Canada

Abstract

Introduction: Many countries in the Organisation of Economic Co-operation and Development (OECD) now use pharmaco-economic assessments in their pricing and reimbursement decisions to restrict the rising pharmaceutical spending. A medicine that has demonstrated cost-effectiveness and is priced cheaply will most likely be funded. In New Zealand, funding decisions are made by the Pharmaceutical Management Agency (PHARMAC) has been both heavily criticised for its lack of access to medicines and admired for keeping pharmaceutical spending constant and within budget. Objective: This is study is to qualitatively explore the access to medicines situation in New Zealand and comparing the situation with Australia, United Kingdom and Canada. Methods: Semi structured interviews with key stakeholders (doctor, pharmacist, patient, government funding agency and pharmaceutical industry) within New Zealand, Australia, United Kingdom and Canada were arranged to discuss their views, perceptions, concerns related to access to medicines. The interview was recorded, transcribed and then coded to identify important themes related to the Access to Medicine Situation. Results/Discussion: 20 interviews were completed for 5 stakeholders in each of the four countries. The key themes identified from this qualitative study includes; the pricing of pharmaceuticals (and how pricing can affect access to medicines); equality in access to medicines; sustainability of the pharmaceutical policy in the long term; and transparency. The different stakeholders provided a multi-dimensional view on the access to medicine situation within each country. The stakeholders of all the countries are generally satisfied with the level of access to medicines, but there were still improvements to be made in their countries' pharmaceutical policy. There is potential for continual research and policy changes have a dual focus of reducing the price of pharmaceuticals and long term sustainability of the innovative pharmaceutical industry. This study is limited by its small sample size and highly qualified interview participants and therefore some views may not be a true representation of stakeholder group. Conclusion: This study explored and evaluated the key themes, perspectives and concerns of the access to medicine situation in New Zealand, Australia, United Kingdom and Canada. More research is required on the potential benefits of addressing key themes and concerns in a pharmaceutical policy.