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

Case 6: “PHARMAC scolded for MS-drug policy” (The Dominion 3/9/99)
In this story, parliament’s Health Select Committee criticised PHARMAC for lack
of progress on subsidising the drug Interferon for people with multiple sclerosis
(MS). The committee was concerned about the financial pressures on MS
patients who were self-funding the drug. The committee was indicating to
PHARMAC, that in their opinion, Interferon should be placed on the
Pharmaceutical Schedule. Multiple Sclerosis Society spokeswomen, Duillia
Rendall also criticised the length of time PHARMAC was taking to establish
criteria for Interferon. She stated that the self-funding of Interferon was placing
many people with MS in extreme financial distress. Wayne McNee explained to
the committee that PHARMAC was working with neurologists for advice about
patients who meet Community Exceptional Circumstances criteria. He told the
committee Interferon was too expensive to subsidise all MS patients.
The Committee gave PHARMAC their opinion that PHARMAC should fund
patients who were self-funding this drug under the Community Exceptional
Circumstances policy. The media report noted that PHARMAC took no notice
of the Health Select Committee and told the Committee they were working
through their processes and would have an answer in due course. This case is
further discussed in Chapter 7 (p.231).
Case 7: New Drug rules ‘a death sentence’ (Evening Post,13/01/1995)
Shirley Newman was a 65-year-old woman who was taking aspirin for a
condition which was not identified in the news report. She was prescribed
aspirin for anticoagulation and her doctor had prescribed a medicine named
dyprimadole as a substitute for aspirin. Shirley claimed to be allergic to aspirin
and she wished to stay on the previous medication which had kept her feeling
very well. PHARMAC reduced the subsidy for dyprimadole and transferred the
subsidy to aspirin. Shirley claimed that because she was allergic to aspirin she
was now required to pay the full cost of dyprimadole. The cost to her was $171
for a 3 month supply which amounted to $2.00 per day. Shirley describes this
as ‘a death sentence’. Shirley had not applied to PHARMAC for a subsidy
under Community Exceptional Circumstances.
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