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Decision criteria review: final decision

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MIL OSI – Source: Pharmac – Press Release/Statement

Headline: Decision criteria review: final decision

Decision criteria review: final decision

24 November 2014

Thank you for your engagement and input into the review of PHARMAC’s Decision Criteria. We have now completed the review and are pleased to present the outcome; which is a new framework for PHARMAC’s decision-making.

The key features of the framework are as follows:

  • A new diagram presenting 15 factors for consideration will replace the current list of nine decision criteria;

Statutory objective

Does the proposal or decision help PHARMAC to secure for eligible people in need of pharmaceuticals the best health outcomes that are reasonably achievable from pharmaceutical treatment and from within the amount of funding provided?

Need

Person receiving the medicine or medical device

The health need of the person

The availability and suitability of existing medicines, medical devices and treatments

Family, whānau and wider society

The impact on the Maori health areas of focus and Maori health outcomes

The impact on the health of population groups experiencing health disparities

Health system (including health workforce)

The impact on Government health priorities

Health benefits

Person receiving the medicine or medical device

The health benefit to the person

Family, whānau and wider society

The health benefit to the family, whanau and wider society

Health system (including health workforce)

Compatibility with the health system

Costs and savings

Person receiving the medicine or medical device

Health-related costs and savings to the person

Family, whānau and wider society

Health-related costs and savings to the family, whanau and wider society

Health system (including health workforce)

Costs and savings to the rest of the health system

Costs and savings to pharmaceutical expenditure

Suitability

Person receiving the medicine or medical device

The features of the medicine or medical device that may impact on use of the medicine or medical device by the person

Family, whānau and wider society

The features of the medicine or medical device that may impact on use of the medicine or medical device by family, whanau and wider society

Health system (including health workforce)

The features of the medicine or medical device that may impact on use of the medicine by the health workforce

  • PHARMAC will take into account factors that impact on the person receiving the medicine or medical device; the impact on family, whanāu of the person and wider society; and the impact on the broader health system;
  • PHARMAC will consider the impact on the health of Māori as a separate factor to acknowledge our commitment to Te Tiriti o Waitangi;
  • PHARMAC will consider the health impact on a broader group of populations that are facing health disparities; this includes the significant disparities that currently exist with New Zealand’s Pacific populations.
  • A supporting information document provides additional explanation for each of the factors for consideration.

Given the significant changes to the decision-making framework, these changes will not come into effect until late 2015. This lead-in time will enable us to make the required changes to our internal processes. It will also enable PHARMAC to engage with our external stakeholders to help familiarise all relevant and interested parties with the new framework and help educate about what the changes will mean for you well in advance of them occurring. We will keep stakeholders informed through our website and via the OPP mailing list. 

Please contact us at opp@pharmac.govt.nz if you are not on the mailing list but would like to be added.

Consultation process

The Decision Criteria review commenced in June 2013, and has included two rounds of public consultation. Consultation documents and summaries of submissions from the consultation period can be found on the PHARMAC website. This includes a response to submissions from the last round of consultation.



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