Pharmac retains role in medical devices despite inability to cut costs
The pandemic reveals flaws
The review said Pharmac was “poorly placed” to coordinate the hugely complex medical device supply chain.
It hit home during the struggle to secure basic medical items in the early stages of COVID-19.
“Those managing the COVID response needed information quickly on the location and number of medical devices, and Pharmac could not provide that information.
“These stocks could not be reallocated and ran out in some regions as others held stock,” the review said.
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Unlike the drugs it firmly controls, Pharmac has signed few contracts with medical device suppliers, including in 2016 for wound care products, which generated “modest” savings.
Device vendors and hospitals are free to resist its influence, and have done so, according to the review, saying it “operates too remotely from clinical and operational issues in hospitals and health services” .
“Pharmac is no longer the most appropriate agency to lead this function. It should move to Health NZ,” he recommended to the government.
Devices added to an extensive catalog
Pharmac’s main achievement, which the government has been keen to focus on, is cataloging 150,000 devices over 10 years, with another 100,000 to come.
But no doctor or hospital is required to use the catalog to purchase devices, and the list can be difficult to use.
Samantha Murton, who chairs the Council of Medical Colleges, searched for a type of diabetes monitor but couldn’t find it among the thousands of catalog pages.
“Admittedly, from a general practice perspective, it’s quite difficult to go through this list and find out what’s available and what’s not,” she said.
“From a hospital perspective, there’s such a wide range of things that I imagine it would be very difficult.”
Murton admitted Health NZ may be too busy to deal with this now, but said something had to change because Pharmac was not protecting taxpayers’ money enough.
“Obviously it’s too complex for it to be effective.
“I think we have to ask ourselves if this is something that we continue to pursue or if we make it a much smaller beast than it is now”, perhaps focusing only on expensive devices , she said.
The review suggested Pharmac should continue its long-running work of developing a way to assess whether the devices were safe and effective, but transfer the cataloging and contracting of the devices to Health NZ – although possibly be gradually, at the pace of Health NZ.
The government’s response has been to reject any transfer at least until a new Therapeutic Products Bill is in place.
This bill, which has been in the works since 2018 and is unlikely to be implemented until next year, aims to correct the glaring lack of regulation of medical devices, a gaping loophole revealed by the harm some women have suffered from surgical mesh.