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

valuing health particularly faced by decision makers who are confronted with
media attention or sustained political exposure. This was seen as pressure
placed on PHARMAC to provide a subsidy for applicants whose applications
have not passed the effectiveness and affordability test. If PHARMAC
acquiesced to such pressure it would have to abandon the utilitarian principle
and invoke the Rule of Rescue. The NICE in the UK has declared that it will
not consider Rule of Rescue applications for pharmaceuticals. PHARMAC has
also been resolute, sometimes evoking considerable unpopularity in applying
the nine decision making criteria instead of reacting to Rule of Rescue claims.
The media study in this research identified leveraging off the anguish and
heartbreak of tragic situations in which people have found themselves. The
media presented the plight of the unfortunate person against the bureaucratic
might of PHARMAC in an adversarial contest. Evidence in the research
showed how PHARMAC staff members were personally pejoratively affected by
this process. One PHARMAC interviewee described how he/she felt when a
family bought an Alzheimer’s patient into the PHARMAC offices to demonstrate
the awfulness of the condition. The interviewee described this episode as
being grossly unfair on both the manager and the patient, and personally
upsetting for all involved.
The media stories showed that when PHARMAC adhered to its utilitarian
approach by requiring satisfactory evidence of effectiveness and determined
their inability to fund a drug, the patient was presented in the media as the loser
and PHARMAC the winner. The media showed no concern if PHARMAC
abandoned its rational approach and no concern for many other people with
other conditions who may have been refused treatment on account of the cost
of a mediagenic rescue.
It is a widespread human desire to want to save endangered lives and to do so
in times of an emergency. This is the moral norm in medical fields and is also
the compassionate proclivity of the media. But the cost of rescue, particularly
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