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

make. And so PHARMAC has been a huge shield for Ministers,
‘cause we can say, “That’s a PHARMAC decision”…it’s been made
independently based on the best research and the best information,
knowledge, international. (Interviewee F)
These decisions were made by the past or present Minister as a result of
pressure from patient advocacy groups. ‘F’ justified this by saying that the
PHARMAC Committees had recommended the listing of the drugs and the
PHARMAC Board had refused, and on occasions Ministers had decided to
intervene.
Q What level of unfairness would it take for you to intervene as
Minister?
A Wouldn’t necessarily only be unfairness… if there was a strong case
put by, evidence based, for example PTAC said, “This ought to be
funded,” and the [PHARMAC] Board said, “No we can’t, or we won’t,
we’ve got other priorities,” that would be one criteria because I feel
as a Minister I was on sound ground with the best brains looking at
the international research that said we should do it.
Q What grounds convinced you to act?
A It would be…clinical effectiveness, I think it has to be. I think that a
group of advocates like the [name withheld] 58 people that have strong
evidence, they did a lot of the collation [of evidence] they almost
became the clearing house for everything that came in…I would have
wanted them to be listened to, but I would, intervene into
PHARMAC’s decision making, so long as it’s transparent, open and
there is an element of consultation and so on in it, I think it’s held us
in pretty good stead. I think in special circumstances that there are
things that they ought to look at. It was such a delicate balance
between interfering and not interfering, it was so finely balanced you
could have unravelled PHARMAC very quickly, and there was a
stage where it looked like the opposition was going to attack
PHARMAC and wanted to change it. (Interviewee F)
58 Name of organisation withheld to protect the identity of the interviewee.
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