Associate Health Minister David Seymour has told Pharmac it is inappropriate for the agency to keep considering the Treaty of Waitangi's place in the health sector.
David Seymour has released his letter to the Pharmac board chair, 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.
"This should serve all New Zealanders based on actual need, without assigning their background as a proxy of need."
He said there was no proof that considering the Treaty was leading to bad health outcomes, but it was a distraction.
"Every moment you're thinking about that, you're not thinking about how do we get to better outcomes," he said. "I think it's going to help all people's health statistics in the same way."
He 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.
"We've got to be open about the fact that sometimes ethnicity's a factor, sometimes it just isn't."
He has also asked Pharmac to update its decision-making and evaluation models to include the wider fiscal impact of funding or not funding a medicine.
For example there had been "almost no lung transplants" needed since funding for trikafta was brought in, he said, which were hugely expensive.
"I come across example after example ... where we simply aren't factoring in the savings that could be made at an all-of-government level."
Seymour also referenced a 2022 review into Pharmac which called for more transparency and timeliness from the agency, and increased input from patients and patient advocates.
He has asked the chairperson to ensure Pharmac has appropriate processes and methodologies for ensuring people living with a disease, and their carers and family, can participate and provide input into the decision-making processes.
Pharmac would also be required to publish how it was progressing on that matter.
The 2022 review also recommended responsibility for medical devices be moved to Health New Zealand. However, the previous government retained the responsibility with Pharmac.
Seymour said he would work with Pharmac's board and the Ministry of Health to better understand the role Pharmac is playing in the value assessment and procurement of medical devices.
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.
Malcolm Mulholland from Patient Voice Aotearoa welcomed the letter of expectations, saying it signalled a new era was beginning.
"Patient advocates are very pleased to see in the letter, the need to update the statutory objectives of Pharmac so that it can assist in the optimisation of health outcomes. This is welcome news," he said.
Bennett said she expected to see change "quite frankly, from today".
"There is a new show in town", she said, "with a new minister, a new government and a new chair, there are new expectations now."
Pharmac had an incredible team that did incredible work, "but I think we are on the precipice of change" with the large increase in government funding for medicines.
"These are exciting times, and I think genuinely exciting times... if we think about where we can head," she said. "They've already got new medicines out there now for consultation."
She 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.
"I know for a fact actually that the social development minister ... I think the next six months for her will be absolutely focused on how she can deliver differently for New Zealanders."
She promised Pharmac would be "listening differently", thinking about the funding process, and justify the funding decisions that were being made, saying it was an organisation that wanted to do better.
