Pharmac director Dr Anthony Jordan has quit over the government's Treaty directive, the Pharmac Minister's office says.
Associate health minister David Seymour this week told Pharmac it was inappropriate for the agency to keep considering the Treaty of Waitangi's place in the health sector.
Seymour has released his letter to the Pharmac board chairperson Paula Bennett, setting out his expectations for the agency.
"Pharmac's role should focus on delivering improved health outcomes underpinned by robust data and evidence, in accordance with its statutory responsibilities," he wrote.
Dr Jordan joined the Pharmac Board in December 2021 and his term was due to end in December 2024.
He said he "could not with good conscience" continue to work for the agency following directions to stop factoring Te Tiriti o Waitangi into its decisions.
After recieving the Treaty directive issued earlier this week, he quit effective immediately following a media conference where Bennett and Seymour spoke, he said.
The removal of Treaty principles from Pharmac did not align with his own morals and ethics, he said.
Seymour told RNZ Dr Jordan informed Bennett he was quitting several days ago.
"He's indicated that he disagrees with the direction set out in my letter of expectation and I actually respect him for making the call.
"If someone doesn't like where an organisation is going, I think the respectable thing is to say it publicly, step down and let others who do agree with the direction get on with it."
Seymour said Dr Jordan's resignation had not given him pause for thought about his letter of expectation - "not at all".
"If there are people who believe that the Treaty and embedding it was more important than equal treatment based on medical need, as Pharmac goes forward, then I actually think it's right for them to be open about that and step down."
Seymour said it would take a minimum of three to four weeks to appoint a replacement for Dr Jordan.
Bennett in a statement said Dr Jordan's decision to resign was effective immediately.
"I am told Dr Jordan has made a significant contribution to Pharmac's strategic direction and operational focus over the past few years.
"Other board members, the chief executive and the teams at Pharmac have greatly appreciated the clinical expertise and insights he has brought to his role on the Board, and we wish him all the best for the future."
Seymour would appoint a new board member in due course, she said.
In his letter to Pharmac, Seymour had also said there were some illnesses and treatments where ethnicity was a factor, and that he had never argued that ethnicity should not be considered in cases where it genuinely was a factor.
Bennett said Seymour's letter had set out clearly the need for Pharmac to consider the voices of all New Zealanders, and highlighted the focus on a social investment approach.
As part of National's coalition agreement with ACT, Seymour has been tasked with reforming Pharmac's funding model, to account for positive fiscal impacts on the Crown of funding more medicines.
Pharmac will be required to update its statement of intent to reflect the government's priorities, and continue to outline how it is implementing the findings from the 2022 review.