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

In Chapter 3, New Zealand’s past attempts to manage health care spending are
discussed. I also provide a context for my research project by discussing the
policy settings, rules and criteria used by PHARMAC in its decision making.
Internationally, PHARMAC has played an important part in demonstrating how
to manage a particularly difficult, uncertain, risk-laden area of public health
provision. New Zealand has one of the rare forms of explicit rationing for
pharmaceuticals, and there have been few empirical research studies done on
how these types of policies are managed.
In Chapter 4, I look at the philosophical framework of justice in which the thesis
question is developed (Prah Ruger, 2010 p79). I discuss the principles of
distributive justice as fairness and equity developed by Rawls and Sen. There
have been many authors who have described the theoretical descriptions of
justice, distributive justice and distributive justice in health. However, few have
given advice about how to apply the theories and much of the literature is
presented in the Socratic fashion posing rhetorical questions about distributive
justice.
Following in this tradition, I have taken the principles of distributive justice, as
presented by Rawls and Sen, and developed them into some test-questions
which enquire into the fairness and equity of decisions which are made. The
test-questions are not intended to extract all the elements of distributive justice
ever presented, but rather to give some structure to the conversation about
fairness and equity. I also present the test-questions so that decision makers
might use them to guide or review their decisions.
Chapter 5 is a description of the qualitative thematic analysis method employed
to conduct the research using the example of PHARMAC’s Community
Exceptional Circumstances. I explain what I did to identify data from five
sources and how the data were managed, particularly using the NVivo 8
(Lavery, 2009b) computer programme. The chapter includes a description of
some of the limitations I experienced in using the tool. Ethical approval was
provided by the Auckland University of Technology Ethics Committee and
ethical considerations are discussed here.
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