Kletchko SL, Moore DW, Jones KL; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1995; 11: Abstract No. 235.

PHARMAC, Wellington, New Zealand.

New Zealand's publicly owned health funders are developing strategies to target medicines: funding a given patient's treatment if and only if doing so is the best use of available health funds. We discuss the strategies in the context of NZ's health funding structures and the process and goals of assessment and public funding of pharmaceuticals. Four government owned Regional Health Authorities (RHAs) purchase health care on behalf of their respective populations. Inpatient pharmaceuticals are purchased by secondary health care providers who are funded through service based contracts with RHAs. Other publicly funded pharmaceuticals are subsidized directly by the RHAs through the national "Pharmaceutical Schedule." PHARMAC, a joint venture company owned by the four RHAs, negotiates directly with suppliers whether and at what level subsidies apply. RHAs seek to closely link clinical decision making based on appropriate practice guidelines with financial accountability for the cost of medicines. Until this link is strengthened, for example by reform of GP funding, a key issue is how to better target medicines to individuals who gain the most benefit from them. Three strategies are: 1) Separate funding and assessment mechanisms for very expensive medicines (over NZ $25,000 per patient per year). Emphasis is on sharing risk with secondary care providers and developing patient based management systems which use guidelines, performance indicators and databases relating inputs to clinical outcomes; 2) Broadening the range of pharmaceuticals directly purchased by secondary health care providers; and 3) Improving targeting mechanisms for medicines subsidized through the Pharmaceutical Schedule. These include better contracting with suppliers (for example, contracting for management of disease states), influencing prescriber behavior (for example, through specialist budget holding for particular pharmaceuticals) and influencing user behavior.

Publication Types:

• Meeting Abstracts

Keywords:

• Budgets
• Delivery of Health Care
• Financial Management
• Health Resources
• Humans
• New Zealand
• Social Responsibility
• economics
• ethics
• hsrmtgs

Other ID:

• HTX/96715008

UI: 102215980

From Meeting Abstracts