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

well placed to lead further research into the question: is it better to try to improve
the health status of Maori by improving access to medicines or by trying to
reduce both social and income inequalities for Maori.
Closing Comments on the Thesis Question
“How does the operation of PHARMAC’s Community Exceptional Circumstances
policy align with the distributive justice principles of fairness and equity as
described by John Rawls and Amartya Sen?”
This research has produced five emergent themes which paint a picture of
PHARMAC making rational allocative decisions about the provision of subsidies
for medicines for the general public. The themes have also demonstrated
PHARMAC’s performance in relation to the management of individuals whose
pharmaceutical needs were described as exceptional.
The arms length relationship between PHARMAC and government has provided
successive Health Ministers with the opportunity to avoid being involved with
claims made by groups or individuals lobbying for access to publicly subsidised
pharmaceuticals. This relationship has also provided PHARMAC the clear space
to make unpalatable decisions which ensure the budgets are achieved. This is
PHARMAC’s statutory purpose.
Consequently, there has been little complaint from governments about
PHARMAC and very few examples where governments have reversed
PHARMAC’s decision making. When the Hon. Annette King intervened to
instruct PHARMAC to fund Interferon for MS sufferers, the Minister claimed to do
so both on the evidence put before her about the effectiveness of the drug
(although PHARMAC experts disputed this evidence), and based on her notion of
fairness and equity to this patient group.
However, my research showed that PHARMAC was seen by some members of
the public (and sometimes their doctors) in a very different light. There was a
view of PHARMAC which was expressed as harsh, bureaucratic and somewhat
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