Lately, there has been a lot of media coverage about New Zealanders facing life threating illnesses and not being able to afford the medication they need because their medications are not on Pharmac’s funding list. In New Zealand, there are many more medications on the Medsafe approved list than there are on the Pharmac list. Pharmac cannot fund all ‘wonder’ drugs as and when they become available – so how does Pharmac decide which medications to fund?
After Medsafe approve a new medication but before Pharmac include it in their funding there are four factors for consideration:
- Health benefits
- Cost and savings and
Pharmac must also agree on a deal with a medical supplier and have the budget to pay for it now and in future years.
If you are someone needing treatment from a non-pharmac drug – then it could be too late. Acting early, by taking out a medical policy that covers you for non-pharmac medicines – that is guaranteed – may save you from significant medical costs in the future.
For some people the risk is real, so what can you do about it?
Today, there are health insurance policies available in New Zealand that you can include in your personal risk management plan that will provide medical cover for Medsafe-approved medication that is not currently funded by Pharmac. This means you can have access to the treatment you need, when you need it, whether it is funded by Pharmac or not.
Is the guarantee worth the extra cost? By having the guarantee, you remove the insurer’s ability to do away with bits of your policy without your consent.
It can seem all a bit too complicated and overwhelming, so we recommend that you talk to your adviser, as not all health insurance policies include non-pharmac drugs and those that do, offer different levels of cover. There are also other options such as Critical care/Trauma insurance and Cancer care, which provide a lump sum that can be used to help fund non-pharmac drugs.
Click here for more information on Pharmac’s processes.