Pharmac’s decision to fund limited access to two new drugs used to treat type 2 diabetes could result in up to 140,000 people dropping out with the condition, a doctor says.
Dr. John Baker, chairman of the Diabetes Foundation Aotearoa, says this needs to change, pointing out the flaws in the government’s drug funding agency’s funding model.
His comments follow the release of documents Pharmac released under the Official Information Act on its decision late last year to fund empagliflozin and dulaglutide, as well as feedback from people in the healthcare sector.
Unlike existing treatments for people with type 2 diabetes, which focus on lowering a patient’s blood sugar levels, the two drugs can also help delay a person’s development of other related complications, such as kidney and heart disease.
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The agency announced in December that it would start funding medication for 53,000 patients with the disease who meet certain criteria starting in February.
But according to Pharmac’s own papers last year, there are 195,000 nationwide taking drugs for the disease. And with 45,266 people in South Auckland with diabetes alone, Baker said this creates an ethical dilemma for specialists like him.
“Who is missing out on that and how do you as a doctor make this decision?”
Pharmac said its role is to get the best health outcomes on a budget and it has received significant feedback from health professionals who support its approach to the drugs.
Diabetes is the country’s largest and fastest growing health disease, and South Auckland is home to the highest number of people diagnosed in New Zealand.
RNZ
A human nutrition and medicine professor says the latest nationwide snapshot of diabetes left him speechless.
The Department of Health estimates that there are 263,938 people with the disease in New Zealand, and it is more common among Māori, Pacific and South Asians.
According to Pharmac, the gross cost of funding the two drugs was estimated at $ 125 million over five years.
“The harsh reality, and the fundamental reason Pharmac exists, is to control costs,” said Baker.
And he said while a parliamentary review of Pharmac’s work was underway, the investigation would not address the agency’s budget.
Stephen Forbes / stuff
Aotearoa Diabetes Foundation Chairman John Baker says newly released figures from Pharmac show up to 140,000 people with type 2 diabetes could miss treatment with two new drugs that were approved late last year.
Baker said Pharmac’s focus should be on prevention, not cost savings.
“The thing about these two drugs, empagliflozin and dulaglutide, is that they are the first to affect outcomes like death, heart disease and kidney failure,” he said.
“This is how the US Food and Drug Administration (FDA) sees it today when it comes to drug approval. It looks for hard results. “
But he said Pharmac is still obsessed with the numbers, which is reflected in the documents released under the Official Information Act on the decision-making process for the two drugs.
“It was more concerned about whether it would be on budget.”
David Unwin / stuff
Malcolm Mulholland of Patient Voice Aotearoa says the sheer number of people who might miss taking empagliflozin or dulaglutide to treat type 2 diabetes is due to the lack of resources available at Pharmac.
Patient Voice Aotearoa spokesman Malcolm Mulholland said he was aware of the criticism made by Pharmac regarding the introduction of empagliflozin and dulaglutide.
“We know that Pharmacy has rationed, and especially with these two drugs. And it boils down to Pharmac not having the money to fund the treatment of the other 140,000 people. “
The group acts as an advocate for people with serious illnesses and has criticized Pharmac for a number of its funding decisions.
“Part of the problem with Pharmac is that the people who make the decisions are supposed to be the experts, but they’re also the bean counters,” Mulholland said. “And they don’t seem to be calculating the social cost of their decisions.”
Pharmac Director of Operations Lisa Williams said that during the consultation process on funding the two diabetes medicines, it had received significant feedback from health professionals who supported its approach.
“Pharmac’s role is to ensure the best health outcomes within our tight budget. If you’re on a tight budget, there will always be more drugs than we can fund, which means we’ll have to make some tough decisions. “
Williams said expanding access to other people who will benefit from the new drugs is something it wants to do when it has the resources available.
“Pharmac will continue to make the best decisions possible and expand the treatments available to all New Zealanders based on a robust, evidence-based approach, just as we have done for the past 27 years.”
It has received 16,497 approved applications for empagliflozin to date, according to Pharmac. While dulaglutide will be available once it gets MedSafe approval.
