Te Whanganui a Tara – Te Pātaka Whaioranga Pharmac is seeking feedback on its rule 8.1b in the pharmaceutical schedule, which is an exception so any medicine used to treat cancer in a paediatric setting is automatically funded without a Pharmac assessment.
Pharmac chief executive Sarah Fitt says they need to better understand the difference that rule 8.1b is making to the lives of children with cancer, their family and whānau, and the people who are working hard to treat and support them.
All cancer treatments currently used to treat children will continue to be funded, she says.
Rule 8.1b was set up when Pharmac took over funding decisions for cancer treatments from district health boards, now Te Whatu Ora, in 2005.
Pharmac is revisiting the rule because concerns have been raised around its fairness when compared with other populations and conditions and the growth in costs of new cancer medicines.
As it stands, rule 8.1b only applies to people treated in a paediatric setting. All adolescent and young adults with cancer and children with other illnesses or diseases do not have the same unrestricted funded access to medicines.
Evidence shows that health outcomes for children with cancer have improved drastically over the last few decades, but Pharmac does not know how or to what extent rule 8.1b has contributed to this.
In 2020, about 93 percent of medicines used to treat cancer in a paediatric setting were already listed on the pharmaceutical Schedule, so rule 8.1b is not used very often. However, the medicines funded through rule 8.1b accounted for about half the cost of all paediatric cancer treatments.
Pharmac has published a detailed document that explores the complex standard of care for children with cancer in Aotearoa and the effect rule 8.1b has, as well as a summary of the key points.”
Consultation on rule 8.1b is open for six weeks from today. Submissions can be made until 5pm, December 14.
Pharmac wants to hear from a range of people and perspectives so they fully understand the management of paediatric cancer care and the impact rule 8.1b has. Feedback will help them understand if the funding approach needs to change.
