How the Government's funding of 54 new drugs will work and who misses out

Kiwis in desperate need of lifesaving drugs are celebrating tonight after the Government announced a significant funding boost for medicine-buying agency Pharmac.  

Pharmac will receive an extra $604 million over the next four years towards 54 new drugs. It is expected to help around 175,000 patients in the next 12 months. 

National had specified 13 new cancer drugs it wanted funded. Under this package, only seven of those will be, but the remainder will be replaced by alternative drugs that are either as good or better.  

There will also be an additional 13 cancer drugs funded, along with a further 28 drugs for other conditions.  

It's a response to an outcry from patients after the promised drugs weren't funded in this year's budget. 

Patients like Vickie Hudson-Craig were hanging off every word of Prime Minister Christopher Luxon on Monday, as the Government announced it would pour millions into Pharmac to fulfil its promise. 

Hudson-Craig has stage four melanoma. Her treatment is unfunded - and one of the 13 promised by National in their election campaign. 

She's currently paying more than $5000 a month for it herself - but her drug wasn't among those named today. 

"I'm really pleased for Pharmac and for New Zealand in general, but on a personal level, a little confused and uncertain still," Hudson-Craig said. 

"It's life or death that I need to be on that drug, and they appealed to people like me - friends and family of mine - people that we know that voted purely because of this policy." 

The promise was a glaring omission in the budget and ministers have been scrambling behind the scenes to come up with a fix to the complex policy problem. 

Because Pharmac is independent from politicians, the Government cannot specify which treatments it should fund. Instead, Pharmac has a waitlist of drugs it wants to fund. These drugs are ranked, but the rankings are kept secret for commercial reasons. 

So, to fund the specific drugs it wants, the Government needed to give Pharmac enough money to fund all the drugs ranked ahead of the 13 promised. 

"Finally, we start to bridge the gap between New Zealand and the countries we like to compare ourselves with in terms of medicine funding," Associate Health Minister David Seymour said. 

"This uplift is enormous, and it also is done in such a way that respects the integrity of Pharmac." 

Blood cancers, like leukaemia, were excluded from National's initial promise and treatment for those will now be covered by the additional 13.  

The other 28 drugs cover conditions like infections, osteoporosis, sexual health, mental health, dermatology, and respiratory and inflammatory conditions.  

Patient Voice Aotearoa chairman Malcolm Mulholland has been campaigning for better access to drugs for five years. 

"There are a lot of faces of patients, both those who are no longer with us and those who are waiting for those drugs to be funded, that I can visualise right now. It's a very emotional time, this is great news," he said. 

It's great news for many patients, but inevitably, there are those who will miss out. 

Maggie Ngatai has advanced breast cancer. 

"There is no mention of the drug I need. They did just mention breast cancer," Ngatai said. "The energy that it takes to deal with the financing side takes away from the healing side." 

Seven of the 13 medicines National promised are on Pharmac's waitlist, so will be funded quickly, with the first available from October or November. 

However, six either need more clinical advice or Pharmac hasn't received applications for them - that's where Hudson-Craig's drug sits. 

For those ones, the Government has pledged to fund an equal or better alternative. 

"I can't give a commitment as to when those six might be able to come forward, but we do know we'll be deploying the whole package October/November," Health Minister Dr Shane Reti said. 

"Anyone that's living with cancer knows that time is critical. You don't know how long you've got, and you don't know how long the drugs will work, so yesterday was too long," Hudson-Craig said. 

But the wait continues.  

Jenna Lynch analysis  

National will be asking hard questions of itself as to whether it should ever go forward promising specific drugs again. The fact of the matter is there was no way to both fulfil its promise and maintain the independence of Pharmac without pumping a bunch of money in and funding other drugs in the process. But any suggestion that was by design should be met with an extreme amount of caution. 

National has apologised for its communication of his policy. They are now saying they had always intended to fund these drugs, but the proximity to last month's budget and the fact they have had to book the cost against next year's budget tells us this was rushed together in the face of a backlash they were not expecting.  

However, politics aside, the result has been a day to celebrate for patient advocates across the country. It will clear over half the drugs on Pharmac's waitlist as it stands today - this really is a game changer for medicine access in New Zealand.