How does the operation of PHARMAC's 'Community Exceptional ...

PHARMAC was criticised in 16 of the news reports, three reports were
generally complementary to PHARMAC and four were neutral.
Key Informant Interviews
PHARMAC’s Community Exceptional Circumstances policy is a form of micro-
level rationing which occurs explicitly between the patient and PHARMAC.
Explicit rationing suggests clarity about how the criteria for such rationing are
applied (Calman, 1994; Mooney, 2003; Scott, 2001; Woods, 2002). This type of
rationing is rare in New Zealand because it is explicit and because PHARMAC
personnel are required to make decisions about denying treatment to patients.
Such activity carries political risk. Interviewing key informants about explicit
rationing was a fruitful method of discovering, not only what they did and how
they did it, but also the deeper layer of their attitudes, values, motivations and
behaviours.
Another important factor in gathering data about the policy was to try to obtain
information about the methods used to apply the criteria. The weighting given
to each criterion, if any, and the thinking and discussion which went on was
important in coming to an understanding of the elements of justice and fairness.
Anonymity was afforded the informants, as agreed with the AUTEC. This was
assured during both the research and reporting phase. This provided them the
space to talk without the risk of unfair criticism, public opprobrium, political
retribution or impacts on their current or future employment.
The area of obtaining primary research data from this source was the most
problematic area in my data collection for the research. At the time, from the
PHARMAC website, I calculated a very small pool of PHARMAC staff were
knowledgeable about the operation of PHARMAC’s Community Exceptional
Circumstances policy.
I approached officials in PHARMAC to introduce myself and to advise that I was
undertaking primary research into PHARMAC’s policy. I was advised that this is
a very small and relatively unimportant area of PHARMAC’s total budget
allocation. I was told that there really wasn’t anything to research.
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