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

Applying the Test-Questions .................................................................................. 75
The Use of the Test-Questions in This Thesis ........................................................ 81
Chapter 5: Research Method ................................................................................... 82
Introduction 82
The Theory of Researching Public Policy ............................................................... 82
Ethical Approval ..................................................................................................... 86
Gathering the Data ................................................................................................. 88
The New Zealand Public Health and Disability Act 2000..................................................... 88
Walsh vs PHARMAC ........................................................................................................... 89
Media Study ......................................................................................................................... 89
Key Informant Interviews ..................................................................................................... 91
Requests under the Official information Act 1982 ............................................................... 96
Thematic Analysis .................................................................................................. 98
Phase One ........................................................................................................................... 99
Phase Two ........................................................................................................................... 99
Phase Three ....................................................................................................................... 104
Phase Four ......................................................................................................................... 104
Phase Five ......................................................................................................................... 106
Phase Six ........................................................................................................................... 106
Chapter 6: Research Findings ............................................................................... 107
Introduction 107
Section 1: The New Zealand Health and Disability Act 2000 ................................ 108
General Provisions of the New Health Act ......................................................................... 108
Recognition of The Treaty of Waitangi .............................................................................. 110
The Establishment of PHARMAC as a Crown Agency ...................................................... 111
PHARMAC Required to Manage Exceptional Circumstances Schemes........................... 112
Submissions to the Health Select Committee .................................................................... 112
PHARMAC’s Exemption from the Commerce Act 1986 .................................................... 113
PHARMAC’s Immunity from Prosecution .......................................................................... 117
Submissions of PHARMAC’s Functions ............................................................................ 120
Submissions on the Inclusion of the Principles of the Treaty of Waitangi in the Bill ......... 121
Submission of the Rationing of Medicines ......................................................................... 125
Request by The Ministry of Health ..................................................................................... 126
Submission on the PHARMAC’s Decision Making ............................................................ 126
Submission on Complementary Medicines ........................................................................ 127
The Select Committee Report-Back on the Submissions .................................................. 128
Section 2: Walsh v. PHARMAC ............................................................................ 128
Description of the Case ...................................................................................................... 129
The Case for the Plaintiffs .................................................................................................. 129
The Nature of Judicial Review in New Zealand ................................................................. 131
The Relevant Functions of PHARMAC .............................................................................. 132
PHARMAC’s Herceptin Decision Making .......................................................................... 133
The Clinical Evidence Supporting Herceptin ..................................................................... 134
The Use of Cost-utility Analysis ......................................................................................... 135
The ‘nine week’ or ‘twelve months’ Debate ....................................................................... 136
Walsh’s Evidence ............................................................................................................... 138
The Decision – PHARMAC Acted Lawfully ........................................................................ 139
The Decision – All Grounds for Appeal Fail ....................................................................... 140
Decision – PHARMAC Did Not Consult Adequately .......................................................... 140
Clarification of Rogers v. Swindon NHS Primary Care Trust ............................................. 141
Decision on Medsafe’s Non-Approval of Herceptin for a nine week Regime .................... 141
Judge Comments on PHARMAC’s Consultation Processes ............................................. 142
Judge’s Concluding Remarks ............................................................................................ 143
Political Decision re Herceptin ........................................................................................... 143
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