ElderNet Interview - PHARMAC Chief Executive Steffan Crausaz
Liam Butler
Steffan Crausaz has been Chief Executive of PHARMAC since 2012, having previously led PHARMAC's commercial and health
technology assessment activities. Before joining PHARMAC in 2003, Steffan trained as a pharmacist in the UK. He also
worked in the pharmaceutical industry (branded and generic) while undertaking his Masters in pharmacoeconomics and
pharmaceutical policy.
Question One:
How are you working to reduce PHARMAC's administrative burden on clinicians?
We realise that health professionals are busy people and that form-filling can be a burden. Because of the high price of
some medicines it is necessary to target their access to certain types of patients, and this requires ensuring patients
meet Special Authority criteria. Prescribers fill out forms to show their patients meet the criteria.
The good news is that as the prices of medicine come down we are able to remove these Special Authority restrictions.
The number of medicines with Special Authority criteria has been falling in recent years and we anticipate this pattern
will continue over the next few years.
Another process that requires clinician input is in making funding applications for individual patients for medicines
not listed on the Pharmaceutical Schedule. This is called the Named Patient Pharmaceutical Assessment (NPPA) policy.
We have moved 42 medicines that were previously subject to NPPA applications on to the Pharmaceutical Schedule. Each
NPPA application requires significant clinician time to provide the detailed information needed to support a funding
application. Moving these medicines on to the Schedule removes the need to make these individual applications and so
reduces clinician workload.
We also expect to see this pattern continue in future.
Question Two:
PHARMAC is recognised for its work to carefully manage brand switches. How can older people learn more about why you
decided to switch brands?
The subsidised brand of a medicine can change for many reasons, sometimes because of decisions PHARMAC makes. What's
important to remember is that the active ingredient of the medicine doesn't change, just the brand. For example, there
are many brands of paracetamol, and all do the same thing at the same dosage levels.
PHARMAC will sometimes fund a generic medicine, an expert copy of the original. Because generic medicines have to have
the same active ingredient as the original medicine, they have the same benefits and risks as the original brand
medicines. Medsafe, which regulates medicines used in New Zealand, makes sure that all medicines available in New
Zealand go through quality and safety checks and that the medicines work.
When PHARMAC makes a brand change, we tell pharmacists and prescribers and, depending on the number of people taking the
medicine and the nature of the medicine concerned, we sometimes also provide information for pharmacists to share with
people. Prescriptions are usually picked up from a pharmacy, so we think this is a good way to get the message to
people.
The PHARMAC website also contains information about brand changes. Our Guide to PHARMAC page includes a fact sheet about generic medicines and brand changes. We also have a section on the website dedicated to specific brand changes. Some recent examples include the antidepressant fluoxetine, the pain relief medicine fentanyl, and several treatments
for mental health conditions.
Your pharmacist or doctor is the best person to talk to if you have any questions about your medicine, but you can also
contact PHARMAC if you want to. You can e-mail us at brandswitch@pharmac.govt.nz with your queries and/or comments about brand changes.
Question Three. How does PHARMAC work to help Government achieve its health target of faster cancer treatment?
We're always on the lookout for new and effective medicines to help New Zealanders improve their health, and one of the
trends we have seen lately is a move to cancer treatments people can take at home.
Historically chemotherapy - pharmaceutical cancer treatments - required hospital treatment or even hospital admission.
But now with the advent of oral cancer treatments, people can often be prescribed medicine they can take at home.
Examples in the past couple of years include funding for bortezomib for multiple myeloma, erlotinib and gefitinib for
lung cancer, and sunitinib for kidney cancer.
Having oral treatments means these people don't need regular hospital treatment. This frees up hospital infusion time
for other patients to get their treatment more rapidly.
About PHARMAC
PHARMAC helps keep healthcare affordable by getting good prices for quality pharmaceuticals. It makes decisions about
which medicines and medical devices are subsidised by considering things like how effective they are, how costly they
are, and how much they will benefit patients.
Originally PHARMAC focussed on medicines that were used in the community. Since then our role has expanded to include
cancer medicines, vaccines, and haemophilia treatments.
PHARMAC also manages hospital medicines and has begun national contracting for hospital medical devices.
Since its establishment, PHARMAC has increased the range of subsidised medicines available for New Zealanders while
staying within an agreed budget each year. www.pharmac.govt.nz
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