Pharmac blamed as diabetics suffer

Pharmac's "stingy" attitude on drug spending is causing many diabetics unnecessary suffering and costing the health system more in the long run, say diabetes experts.

In a letter to Pharmac's medical director, Dr Peter Moodie, Auckland diabetes physician Paul Drury says while the government's drug-buying agency gave value for money, it was now doing so "at the cost of extreme rationing and restriction in many areas".

"On a per patient basis, funding for diabetes medication and supplies has significantly decreased over recent years while we have been experiencing a diabetes epidemic."

Dr Drury, who served on Pharmac's diabetes sub-committee for eight years before resigning in 2006, told The Dominion Post clinicians were "frustrated" by the lack of progress.

"Just this week Pharmac has finally approved joint use of ace inhibitors and ARBS to protect kidneys, four years after this was recommended.

"Potentially, there are 100 people out there in end-stage renal failure who could have been spared that . . . dialysis is not pleasant and it costs $30-$70,000 per patient per year – a lot more expensive than the drugs."

New Zealand had fewer diabetes treatments available than any other developed nation, even on a restricted access basis, he noted. "This is fine for most patients, but God help you if you're an atypical case and the common drugs are ineffective for you, because it's incredibly difficult to get alternatives."

Diabetes NZ president Mike Smith said there were a number of people who did "not fit the schedule" of subsidised drugs.

"There have been some advances of late, but there are still huge discrepancies in what's available here, compared with Australia."

Dr Moodie said Pharmac had taken Dr Drury's "excellent" suggestions on board but he defended Pharmac's cautious policy on new drugs.

"The newest drugs are not always the best drugs by any means, experience shows," he said, citing the example of glitazones, which are associated with increase risk of heart failure.

He acknowledged Pharmac was spending less per patient, but argued this was because the drugs had got cheaper.

"It's meaningless to look at the spending, but if you look the number of prescriptions, you'll see they have been increasing at a much higher rate."

Spending on diabetes medication has increased two-and-a-half times, from just over $10 million in 1993 to $26.3 million in 2007. In the same period, the number of prescriptions has increased almost three- fold, from 247,335 to 722,618.

He denied Pharmac "underspent" its budget.

- © Fairfax NZ News