Question

David Cunliffe

Judy Turner

Sue Kedgley

Heather Roy

Jackie Blue

Labour

United Future

Greens

Act

National

1. Do we spend enough on pharmaceuticals?

The health budget has increased under Labour. He makes no apology for Pharmac; it saves us $1billion a year which can be invested in healthy NZers.

Prevention is important. Current level of pharma funding is on the low side, but we still need a cap. Needs to be principle-based spending.

Acknowledges that some medicines are lifesaving but doesn’t accept that spending more will result in better health. Healthy food is the best medicine.

We lag a long way behind the countries we like to compare ourselves to. Patients and clinicians need to be in the driving seat.  We need to make better use of the money spent on health.

National will spend more. Our per capita spend on pharmaceuticals has decreased, our hospital productivity is down.

2. Should clinical assessment of new drugs be separated from purchasing decisions about them?

Really interesting question; still trying to get his head around it. PTAC’s advice to Pharmac is independent and published on their website. The semi-bundled system we are moving to will have more transparency.

PTAC and Pharmac seemed symbiotic to her at first, but now she is persuaded that they are not, but there should be more transparency so others can see that.

It’s fine the way it is; we have a limited budget, so we have to ration; someone has to make the hard decisions.

We must have independent assessment of clinical efficacy and purchasing decisions.

Not National policy but are concerned about Pharmac. Need more transparency.

3.  Are the workings of PTAC and its sub-committees sufficiently transparent?

Supports the current structure and also the reform to it outlined in Medicines NZ strategy.

There are “perception problems” about the link between PTAC and Pharmac; more transparency would help

Supports more transparency and reporting for all health decisions, including the reasons for the decisions.

They have insufficient transparency. As a spender of taxpayers’ money, the health sector needs more accountability

National has concerns about these committees; the public and pharmaceutical  companies have no access to them and no way of appealing their decisions but to go to court and Pharmac has a substantial legal risk fund to protect them when this happens.

4. Should Pharmac’s statutory exemption from the anti-competition parts of the Commerce Act be repealed?

No; Labour voted against Roy’s Bill; the Medicines NZ strategy does not cover this; anyway Pharmac does not sell drugs it funds subsidies.

No; currently supports the status quo. NZ too small to be exposed to an unfettered free market.

No. Supports the status quo; otherwise might result in costly litigation which would cut into the health dollar.

Yes. This was the subject of a Bill Roy put before the House; it was thrown out but she will raise it again if there is a change of government.

Yes. Pharmac itself says it doesn’t need it. Supports Roy’s Bill.

5. What is your party’s policy on direct-to-consumer advertising for medicines?

Ministry of Health has consulted the public about this; there is no need for a change.

OK. It’s legal to sell them, so it should be legal to advertise.

Not OK. Should give consumers unbiased information rather than advertising. Advertising encourages patients to demand medicines and they can have nasty side-effects.

Should stay as it is now. There are guidelines. It is offensive to doctors and patients to suggest that advertising leads to inappropriate prescribing.  Even if advertising were banned, people would consult the internet; this is a freedom of speech issue.

Doctors should discuss drug choice with their patients. Advertising is OK but need information on risks and benefits.

6. Should there be partial funding for pharmaceuticals awaiting Pharmac listing, instead of the current  ”all or nothing” situation?

Reducing inequity is a priority in health care, so don’t support change. It could jeopardise Pharmac ‘s current strong negotiating position.

Yes. Agree with Act, choice is a good thing.

Happy with Pharmac. Partial funding would create inequity of access.

Yes, Act would look at partial funding; endorses Blue’s view; present system is denying patients choice and clinicians valuable experience with different drugs.

National would speed up the process so drugs would not take so long to be listed by Pharmac.

7. What are your views on using Pharmac to centralise purchasing control of medical devices?

Pharmac does list some medical devices; it’s a case-by-case situation.

Not convinced there is a need for change.

Not convinced there is a need for change.

Pharmac should not control purchasing decisions on devices. it’s very competitive now; leave it alone.

If it ain’t broke, don’t fix it. NZ already gets good prices and choice of devices and there is currently goodwill between the companies and health providers.

8.  Do you support progressing the Therapeutic Products & Medicines Bill?

Labour introduced it but there is now another government in Australia; needs time to think about it. The framework needs an upgrade; will be discussing it further.

United Future was influenced by lobbying by complementary medicine people. The government bungled on this one.

The Bill was heavy-handed on dietary supplements. Need separate regulation. Evaluating safety of medicines is costly; we should consider recognising registrations granted overseas in some cases

Act is committed to closer relations with Australia but not to the detriment of NZ business. Need to separate complementaries and food from medicines.

If natural health products were excluded then National would consider it but there are other issues for NZ business involved. NZ could unilaterally recognise registration given in other countries in some cases.