Who is PHARMAC and what do they do?
Fortunately for us Kiwis, we have PHARMAC who are a government funded agency that decides which medicines and related products are funded in New Zealand.
They decide what treatments they subsidise to make drug treatment more affordable or even free, but they have a limited budget and have the task of deciding which treatments they subsidise which also means which ones they cannot. I use the word cannot because if they could afford to, I am sure they would.
Here are some facts you should know about PHARMAC
- In the 2019/2020 years PHARMAC managed over $1 Billion dollars on medicines for New Zealanders
- 3.74 Million people receive funded medicines each year.
- PHARMAC is the only agency in the world that both, decides what medicines to fund and manages a fixed budget for those medicines.
What treatments are funded by PHARMAC?
Firstly, for any drug treatment to be considered my PHARMAC, they must first be approved by Medsafe, which poses another question, who are Medsafe?
Medsafe is the New Zealand Medicines and Medical Devices Safety Authority. It is a business unit of the Ministry of Health and is the authority responsible for the regulation of therapeutic products in New Zealand and any drugs funded by PHARMAC must be approved by them first.
Can I get treatment that is not funded?
If you needed drug treatment that is not funded by PHARMAC, you would need a rather large bank account, or you could have private medical insurance. I am sure you have seen Give-a-little pages raising funds for treatment, and the generosity of New Zealanders is always amazing but reliant on a lot of generous people with big hearts, but that is not the best way to get the treatment you need if it is not funded.
In the end, someone still pays, whether it’s giving to a cause, medical premiums, or not getting the treatment at all, there is always as cost. It’s just who pays, how much and when.
Most health insurers will pay for drug treatment not funded by PHARMAC but there are still policy terms and conditions that need to me adhered to, and policy limitations on how much you could claim each year. At least with a private insurer you know what your covered for and what you are not covered for, it’s in black and white in your policy document. At least you know where you stand and what the cost is.
If you want to make sure you can get the right drug treatment whether it is funded or not, you would be best to contact and get the right advice.