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

treatment was not unusual and the clinical circumstances described were not
sufficiently unusual.
No reason, ground, rationale or elaboration on the criteria by the Panel was
given. No comment was made in reply to the GP about the Panel’s view of
Lyprinol as an acceptable alternate to Diclofenac and Ibuprofen the patient was
taking.
Fourth Official Information Act Request (MidCentral DHB)
Details of the fourth OIA request to Mid Central DHB are also presented on
page 73.
On 6 th January 2011 a letter was written by the Chief Medical Officer, Dr. Ken
Clark on behalf of the Regional Cancer Treatment Service provided by
MidCentral DHB. The service for cancer patients covers a population of
555,000 people over a catchment area which includes Gisborne (Tairawhiti),
Hawke’s Bay, Taranaki, Whanganui and Wairarapa.
I requested the letter under the OIA. I also requested all the information which
was placed before the decision making group of doctors by way of journal
articles, studies, reports, letters to or from officials and emails. I wanted to
enquire as to what evidence supported the decision.
I was provided with the letter in which Dr. Clark advised the health managers
and Chief Medical Officers that the MidCentral DHB that some cancer patients
were going to be ‘triaged’ or refused chemotherapy treatment.
The MidCentral DHB advised me that no written material was put before the
decision makers by way of evidence. The decision was made on the basis of
the doctors ‘clinical experience’.This case is fully discussed earlier in Chapter 4
(Philosophical Framework).
Section 6: PHARMAC Initiated A Review of the Exceptional
Circumstances Policy
In this section, I present data from a significant review which was carried out
reviewing PHARMAC three Exceptional Circumstances schemes between
November 2010 and July 2011.
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