Some patients and advocacy groups see Pharmac as “slow to respond”, “highly defensive” and “lacking respect” for them, according to an independent report released by the drug-funding agency today.
The report – commissioned by Pharmac’s board and based on workshops held late last year – found there was “a credibility and trust gap”.
Pharmac chairwoman Paula Bennett said it was intended to support its “wider reset” to become “more outward focused”.
“We’ve heard very clearly that we need to make sure our interactions are respectful and meaningful, and that people’s voices are valued and included throughout our work,” Bennett said.
The agency has come under mounting scrutiny in the the last year, with 100,000 people signing a petition to Parliament in December calling for chief executive Sarah Fitt to be sacked.
She resigned last month after seven years in the top job.
The first workshop in November, chaired by former Wellington mayor Dame Kerry Prendergast, included presentations and personal experiences from 30 participants, who said:
- Consultation with patients/consumers were “uneven, unequal and inconsistent”
- Pharmac’s culture was “slow to respond”, lacking respect, and “highly defensive when called to account”
- Pharmac did a poor job of explaining how the assessment process works
- There was widespread frustration about lack of progress on previous recommendations in 2022 and 2024.
At a second workshop, Bennett and Pharmac management fronted up to respond to questions from the participants at the first workshop.
In her final report, Dame Kerry wrote that “session ended with no real movement on any of the issues discussed”.
“The workshop mood was that nothing new was learned from Pharmac’s formal responses, and that management had lost an opportunity to be more open / less defensive when dealing with the consumer/patient representatives present.”
Following small group discussions, there was universal agreement among workshop participants that Pharmac’s Health Technology Assessment (HTA) processes were “flawed” and the model required a complete overhaul rather than “tinkering”.
For instance, several participants criticised the fact that as soon as Pharmac received a funding application for a medicine, any new patients were blocked from receiving that medicine under the Named Patient Pharmaceutical Assessment (NPPA) route for that condition.
As one participant noted: “This is a particularly cruel policy that deters submitters from submitting a proposal as this will harm patients. This policy should be overturned with urgency.”
The workshops did not come up with a list of prescribed actions that would “reset” Pharmac’s relationship with patients, Dame Kerry wrote.
“Nor did the workshops narrow the ‘trust and respect’ gap between Pharmac management and many participants.
“That is an incremental process that will require time, tolerance and goodwill on both sides of the table.”
However, participants did not want their feedback at the workshops “parked” because they had not managed to come up with specific recommendations, she said.
Dame Kerry has recommended setting up a reference group of up to eight people from the consumer/patient representative community to work in partnership with Pharmac management.
The group’s focus could cover:
- Improving Pharmac’s communication processes
- Improving the approval process
- Developing a “fast track” process for medical technology
- Administration and supply issues that create “needless cost and hardship” for patients.
Bennett said the board had proactively released the report of the workshops to “demonstrate the organisation’s commitment to change and being transparent”.
“There’s a lot for the Board and Pharmac’s senior management to think about, and we’re considering the next steps. This work is part of a wider reset for Pharmac to become an outward-focused organisation. The team at Pharmac does an amazing job and we’re committed to meaningful change to strengthen Pharmac’s relationships with consumers.”
rnz.co.nz
