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

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PHARMAC has been extraordinarily successful at managing New
Zealand’s pharmaceutical budget by providing an adequate supply of
quality pharmaceuticals for the lowest cost per drug category in the
OECD.
PHARMAC’s Community Exceptional Circumstances is a rational way of
managing exceptional individual claims, however the decision making
criteria have been applied primarily to control PHARMAC budgets.
PHARMAC is held accountable to the government through public policy
reporting mechanisms, Parliament, the New Zealand Courts and the
media. However, PHARMAC has regularly been criticised for not
explaining its decisions to Community Exceptional Circumstances
claimants and the pharmaceutical industry.
PHARMAC does not have a stated philosophical position but operates as
a utilitarian agency aiming to provide the highest level of benefit for the
greatest number of people. It sometimes does this at the expense of
people who have rare conditions or whose needs are considered
exceptional.
Ministers of Health King and Ryall have both intervened in PHARMAC’s
decision making process by directing that selected drugs be made
available when PHARMAC had decided against the subsidisation of
these drugs.
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