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

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The Names of Each Theme I have given each theme a name which captures the essence of the theme. They are: Theme 1. PHARMAC the success story Theme 2. Inconsistently applied criteria Theme 3. PHARMAC is accountable Theme 4. PHARMAC - No stated philosophy Theme 5. Political interference in PHARMAC In the next chapter, I discuss these themes (referring to the names of the themes) utilising the test-questions based on Rawls and Sen’s principles of distributive justice to identify the content of distributive justice encased in these themes. 216
Chapter 7: Discussion Introduction In the Philosophical Framework in Chapter 4 of this thesis, I developed a series of test-questions which encapsulated the principles of distributive justice as described by Rawls and Sen. The Research Findings in Chapter 6 presented the regularly occurring themes that were extracted from the research data on the subject of PHARMAC’s ‘Community Exceptional Circumstances’ policy. In this chapter, I have chosen to use the test-questions as a framework for a discussion about the regularly occurring themes that emerged. I have used each test-question to examine the themes (as well as some excerpts from the literature) to demonstrate PHARMAC’s performance 69 . However I have made an exception in the case of Theme 5. I have discussed Theme 5 on its own because it relates to the actions of Ministers and PHARMAC had no control over these circumstances. Test-Question 1 “Would the most advantaged in society accept this distribution if they, at an instant, found themselves to be the least advantaged in society and requiring such distribution for themselves?” PHARMAC has two differing purposes under the New Zealand Public Health and Disability Act (2000). The first purpose is to manage the subsidisation of community and hospital pharmaceuticals within the budget that has been set by government. The second purpose is to manage the subsidisation of the 69 I have chosen to examine the test-questions against the themes not the themes against the test-questions. This is because the thesis question asks how PHARMAC’s policy aligns with the principles of distributive justice. The question does not ask how the principles of distributive justice align with the PHARMAC policy. 217
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How does the operation of PHARMAC
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Applying the Test-Questions .......
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Appendix 9: Analysis of Material Re
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List of Abbreviations ABS Australia
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Attestation of Authorship I hereby
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I gratefully acknowledge Major Camp
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Abstract This thesis explores how g
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Chapter 1: Introduction What is thi
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making? Should a person’s level o
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there is no mathematical calculatio
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health, disability, treatment of ol
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I then moved to the subject of rati
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In Chapter 3, New Zealand’s past
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Chapter 2: Background Introduction
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The following journals have no auto
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Technological and pharmaceutical di
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in every sense, and attenuates the
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waiting time for first (or subseque
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Macro-Level Distributions Macro-lev
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(2000) in a report for the Ministry
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level, too many to discuss here. On
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effectiveness of treatment. However
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surgical treatment for ectopic preg
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In a study conducted by the Commonw
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They claim that health inequities c
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these presentations are correct, th
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waiting list for patient priority.
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care within finite resources. The c
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to pay for this co-operation. In 20
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Other results showed that 81% of th
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may be grounds for litigation. Henc
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determine if decisions on the appli
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Chapter 4: Philosophical Framework
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extra person with a good or service
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just actions by individuals. The th
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among the members of the society, a
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example of well off and powerful pe
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necessarily much advantaged over a
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among individuals and communities.
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needs. This was because distinguish
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systematic and transparent. In her
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why PHARMAC would subsidise unecono
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parents refusing treatment for thei
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The first two test-questions covere
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There was no clarity provided by th
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good may be served by their not rec
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Evans (2003) ranked the various typ
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The Use of the Test-Questions in Th
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Qualitative research methods were d
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equirements and considerable politi
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material and by working through the
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and printed copies of Hansard are a
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PHARMAC was criticised in 16 of the
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I tried to find an interviewee from
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The flow of discussion in the inter
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that the disclosure is commercially
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6. Producing the report The final o
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The following tables outline the no
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Table 3: Tree Nodes Used in NVivo A
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At this point, I stopped using NViv
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Chapter 6: Research Findings Introd
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DHBs were given the role of funding
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These measures were in response to
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Table 5: The Submitters to the Heal
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towards New Zealand and for them to
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monopolies as such. In their opinio
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for the delivery of such services (
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NCWNZ that S42(a) of the Bill, requ
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contentious among Maori Iwi. Any Ma
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Dugdale further advised that if non
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cumbersome and recommended that PHA
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following text, I have individually
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Herceptin. The plaintiffs forwarded
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the treatment of cancer in the DHB
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eligible people in New Zealand and
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confirmation that the DHB hospital
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the eight women involved in this ca
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the plaintiffs adequate opportunity
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Judge’s Concluding Remarks The fi
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A Selection of the Media Stories Ca
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Case 4: “Worn out by endless figh
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Case 6: “PHARMAC scolded for MS-d
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The drug to treat Pompe’s Disease
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The Voice of Patients and Family Me
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Sclerosis Society did this three ti
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was suffering would not pass the ra
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Eight of the twelve persons approac
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Part II: The Key Informant Intervie
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agreed this was done. Secondly, PHA
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Page 181 and 182: No we have never thought that $3 mi
Page 183 and 184: Insights were given as to the indep
Page 185 and 186: and Now some people can say that’
Page 187 and 188: Q Be a voice for the family? A Yes,
Page 189 and 190: key issue here. Some clinicians wer
Page 191 and 192: I deeply suspect that Community Exc
Page 193 and 194: should be developing the capacity o
Page 195 and 196: make. And so PHARMAC has been a hug
Page 197 and 198: and PHARMAC is not above rationing
Page 199 and 200: This case demonstrated that the cos
Page 201 and 202: and budget management. It says this
Page 203 and 204: Q Do you recall the Kaletra issues
Page 205 and 206: Q Can I ask you about PHARMAC’s c
Page 207 and 208: ….successfully…for things espec
Page 209 and 210: This was also done for the hard cop
Page 211 and 212: The Ministry of Health could not lo
Page 213 and 214: consultation documents which relate
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Page 217 and 218: with the application. The discharge
Page 219 and 220: Again no report was attached from t
Page 221 and 222: The patient was also prescribed pre
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Page 225 and 226: treatment was not unusual and the c
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Page 229: Theme 1. Theme 2. Theme 3. Theme 4.
Page 233 and 234: the intellectual property to recove
Page 235 and 236: The use of QALY’s was tested in t
Page 237 and 238: Test-Question 2 “Is this distribu
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Page 241 and 242: (2011-2012) in an open and transpar
Page 243 and 244: The cost-utility analysis system ha
Page 245 and 246: Another form of decision making use
Page 247 and 248: discuss how (or if) PHARMAC meets t
Page 249 and 250: Test-question 4 also raises the pro
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Page 257 and 258: Interferon available to a limited n
Page 259 and 260: challenges are multiple: to identif
Page 261 and 262: The data from the research showed h
Page 263 and 264: PHARMAC could be more open about st
Page 265 and 266: Chapter 8: Conclusions Introduction
Page 267 and 268: Limitations to the Research The ite
Page 269 and 270: There is no one set of indefeasible
Page 271 and 272: to alcohol and drug treatment or th
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Page 279 and 280: Appendices: Appendix 1: Ethics Appr
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Appendix 2: Key Informant Participa
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Appendix 3: Key Informant Consent F
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Appendix 4: Sample Interview Questi
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Appendix 5: OIA Request Greg Coyle
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Appendix 6: OIA Response from PHARM
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Appendix 7: Community Exceptional C
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Appendix 8: Community Exceptional C
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Ashton, T., & St John, S. (2008). N
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Cohen, G. A. (2008). Rescuing Justi
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Dew, K., Cumming, J., McLeod, D., M
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Glubb, N. (2011). Official Informat
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Holt, S., Harwood, M., Aldington, S
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Lindblom, C. E. (1959). The Science
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http://www.moh.govt.nz/moh.nsf/ea60
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Cash Flows (Ed.), Government of New
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PB/132 National Council of Women of
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Romano, C. (2009). Amartya Sen Shak
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Swedish Parliamentary Priorities Co
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