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

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12. What improvements could be made to PHARMAC’s policies or operations to ensure the interests of the patients or the interests of the health service are better served? (Approved by the Auckland University of Technology Ethics Committee Ethics Application Number 07/196.) 272
Appendix 5: OIA Request Greg Coyle 142 Upland Rd Kelburn Wellington gregjo@clear.net.nz ph. (04) 977 5333 Matthew Brougham Chief Executive PHARMAC P.O. Box 10-254 Wellington Dear Mr. Brougham, Request under the Official Information Act 1982 I am a PhD student studying at the Auckland University of Technology writing a thesis on the rationing of health services. My OIA request is for the following information; 1. Policy documents PHARMAC has on the preparation and implementation of the ‘Exceptional Circumstances’ policy. This includes Community EC, Hospital EC and Cancer EC 2. PHARMAC Board minutes which are available to the public which discuss Exceptional Circumstances policy or cases. This includes Community EC, Hospital EC and Cancer EC 3. Any papers or articles published by PHARMAC on Exceptional Circumstances. This includes Community EC, Hospital EC and Cancer EC 273
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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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the pharmaceutical schedule. The or
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No we have never thought that $3 mi
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Insights were given as to the indep
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and Now some people can say that’
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Q Be a voice for the family? A Yes,
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key issue here. Some clinicians wer
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I deeply suspect that Community Exc
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should be developing the capacity o
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make. And so PHARMAC has been a hug
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and PHARMAC is not above rationing
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This case demonstrated that the cos
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and budget management. It says this
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Q Do you recall the Kaletra issues
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Q Can I ask you about PHARMAC’s c
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….successfully…for things espec
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This was also done for the hard cop
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The Ministry of Health could not lo
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consultation documents which relate
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The following information was recei
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with the application. The discharge
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Again no report was attached from t
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The patient was also prescribed pre
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circumstances described were not su
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treatment was not unusual and the c
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their clinical circumstances would
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Theme 1. Theme 2. Theme 3. Theme 4.
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Chapter 7: Discussion Introduction
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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
Page 251 and 252: when there is no profound evidence
Page 253 and 254: for example value for money, equity
Page 255 and 256: Community Exceptional Circumstances
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 275 and 276: utilitarian principles of attemptin
Page 277 and 278: stand up to the same rigorous clini
Page 279 and 280: Appendices: Appendix 1: Ethics Appr
Page 281 and 282: Appendix 2: Key Informant Participa
Page 283 and 284: Appendix 3: Key Informant Consent F
Page 285: Appendix 4: Sample Interview Questi
Page 289 and 290: Appendix 6: OIA Response from PHARM
Page 291 and 292: Appendix 7: Community Exceptional C
Page 293 and 294: 279
Page 295 and 296: 281
Page 297 and 298: 283
Page 299 and 300: Appendix 8: Community Exceptional C
Page 301 and 302: Ashton, T., & St John, S. (2008). N
Page 303 and 304: Cohen, G. A. (2008). Rescuing Justi
Page 305 and 306: Dew, K., Cumming, J., McLeod, D., M
Page 307 and 308: Glubb, N. (2011). Official Informat
Page 309 and 310: Holt, S., Harwood, M., Aldington, S
Page 311 and 312: Lindblom, C. E. (1959). The Science
Page 313 and 314: http://www.moh.govt.nz/moh.nsf/ea60
Page 315 and 316: Cash Flows (Ed.), Government of New
Page 317 and 318: PB/132 National Council of Women of
Page 319 and 320: Romano, C. (2009). Amartya Sen Shak
Page 321 and 322: Swedish Parliamentary Priorities Co
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