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

PHARMAC Required to Manage Exceptional Circumstances Schemes
The Bill required PHARMAC to manage incidental matters arising out of the
pharmaceutical subsidy including a policy for dealing with members of the
public who make claims in Exceptional Circumstances. In this way, PHARMAC
would legally provide subsidies to applicants for the supply of pharmaceuticals
which are not on the pharmaceutical schedule (NZPHD Bill section 48(b)[a]).
The government preferred PHARMAC to decide, on behalf of all 21 DHBs,
which pharmaceuticals should be listed, which subsidies should be provided for
them and the eligibility criteria which applied to them. This included managing
people who had exceptional pharmaceutical needs. These decisions could then
be made consistently across the 21 DHBs. The intention of the Bill was to
provide assurance that patients in one DHB would receive the same subsidy
and treatment of their exceptional circumstances as patients claims in another
DHB.
In order to maintain and manage the Pharmaceutical Schedules, PHARMAC
was given a notional budget for itself to pay for staff and operations. This was
to be set by the Minister each year after consultation between PHARMAC and
the DHBs.
Submissions to the Health Select Committee
Members of the public were invited to make submissions to the government on
the NZPHD Bill 1999. There were 153 public submissions received by the
Health Select Committee on the Bill. Of these 153 submissions, 16
organisations or individuals who submitted material on PHARMAC are identified
in Table 5 below.
The likely reason for the low number of submissions received on PHARMAC
may be related to the fact that PHARMAC had already existed as an
organisation on the public health landscape for 6 years since 1993.
The issues raised by submitters in relation to PHARMAC are discussed in the
following section.
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