Todd McClay Speech: Medicines Transform Lives” Conference
Hon Todd McClay
Associate Minister of Health 9 October 2013
Address to “Medicines Transform Lives” Conference, Langham Hotel, Auckland
Thank you for inviting me to speak at Medicines New Zealand’s “Medicines Transform Lives” Conference. I would especially like to thank and acknowledge the Hon Heather Roy, the Chair, Kevin Sheehy, the General Manager, and the directors and members of Medicines New Zealand.
I’d like to talk today about some of the work that the National-led government has been doing in the medicines area, and some of the many achievements that we’ve had. The Government’s Medicines Strategy is outlined in Medicines New Zealand. We want a medicines system that makes sure:
medicines are safe and effective;
· people have access to the medicines they need; and
· that medicines are used effectively.
The Medicines Strategy is supported by an Action Plan, which was released in 2007 and updated in 2010. I think it’s appropriate to acknowledge the good work of the Honourable Peter Dunne in progressing the strategy and action plan. Significant progress has been made on the majority of the actions in the Action Plan, with over a third now complete, and I’d like to take a moment to highlight some of this progress.
Actions where significant progress has been made From 1 April 2013, PHARMAC has listed an additional eleven unregistered medicines on the Pharmaceutical Schedule, reducing the administrative burden for clinicians to access these medicines. It is estimated that at June 2013, 175 patients benefited from this new arrangement. This number is estimated to increase to 1,000 patients by June 2014 and 1,500 patients by June 2015.
In July 2012, PHARMAC took on management of vaccines funding, procurement and prioritisation, and from 1 July 2013, management of hospital medicines. In addition, Cabinet has agreed that PHARMAC will begin to assume responsibility for the procurement and management of medical devices from July 2015, with full responsibility from 2016.
These changes will allow New Zealand to have the same access to hospital medicines, regardless of where they live. No more postcode prescribing. They will also lower overhead costs, and translate into savings that can be channelled back into our health sector.
This government has increased PHARMAC funding from $653 million in 2008/09 to $795 million this year, with around 400,000 more New Zealanders benefitting from improved access to pharmaceuticals as a result.
The Medicines Amendment Bill is another way we are making sure that New Zealanders get better, more convenient access to the medicines they need. The Bill does this by supporting more non-medical health professionals to work to their full capability:
· making nurse practitioners and optometrists authorised prescribers (in line with their scope of practice) – alongside dentists, diabetes specialists, midwives and medical practitioners, and
· creating a new category of delegated prescriber, which will open up another prescribing option for non-medical health professionals.
Likewise, on 1 August this year, Clinical Pharmacists who have completed new training became eligible to prescribe certain medicines to patients. These Pharmacist Prescribers will work as part of a hospital or primary care team to ensure that patients are on the best medicine, at the right doses – further enhancing the quality, safety and convenience of treatment for New Zealanders.
The New Zealand Formulary was launched in 2012 and provides on-line independent, clinically validated medicines information for all health professionals. The Formulary’s objective is to improve the quality of prescribing decisions. Uptake of the Formulary has been particularly pleasing with over 7000 unique IP addresses accessing it in the year to date and over seven and a half million pages viewed.
I can also report that the most viewed chapter was on the central nervous system – which may or may not have had something to do with the frayed nerves from the America’s Cup.
I am pleased with the progress that has been made to date on the medicines action plan, but we should not rest on our laurels. The Ministry of Health has initiated work to update the plan with new actions to further improve and expand our system and I look forward to seeing progress in this area.
In addition, there is also a considerable amount of work currently happening that is not reflected in the Action Plan. Important examples include enhancing the role of pharmacists and diabetes nurse specialists, which I’d like to touch on briefly.
Enhanced role of Pharmacists The Community Pharmacy Services Agreement that came into effect on 1 July 2012 introduced a new service and funding model across all community pharmacies in New Zealand. The model expands the role of community pharmacists from just dispensing medicines to actively working with patients – particularly those with the most complex conditions or co-morbidities, or who are struggling with meeting the requirements of a medicines regimen.
It is appropriate to note that this initiative arose from the confidence and supply agreement between National and United Future.
This new funding model will allow pharmacists to focus on building on-going relationships with patients, better understanding their needs, and helping patients to better manage their medicines over the long-term.
I believe it will better use the skills and expertise of pharmacists and reinforce their role as an integral part of the primary care services team – a role that is long overdue.
I expect this funding model to be fully implemented by July 2014. Pharmacists are now providing more services to their communities in a variety of ways. A 2011 pilot found that management of warfarin treatment by community pharmacists, in collaboration with general practices, is safe and convenient for patients with heart disease. A staged rollout of this service is being undertaken, with a minimum of 70 pharmacies to be providing the service this financial year.
Closer management by community pharmacists also frees up time for GPs and practice nurses. The service is now being implemented more widely across the country. Pharmacists who have completed specific training in the treatment of urinary tract infections are now permitted to sell tri-meth-o-prim without a prescription due to the reclassification of the drug. This has enabled women with urinary tract infections in the community to have more timely treatment.
Pharmacists have also been enabled to administer the influenza vaccine in the community following training, thus increasing community access to this vaccine. There are now around 200 pharmacist vaccinators. The Ministry of Health has recognised the important contribution of pharmacists and strengthened its clinical expertise in pharmacy through the appointment of a senior clinical pharmacist, who I meet with regularly.
Diabetes nurse specialists Diabetes nurse specialists can now prescribe within their scope of practice, following a successful pilot in 2011-2012. This has improved the quality of care for patients with diabetes. Current Government policy is to roll out diabetes nurse prescribing throughout the country.
Australia New Zealand Therapeutic Products Agency (ANZTPA) In addition to the significant work that has been made on the Medicines Strategy and Action Plan the Ministry is continuing its work to progress the Australia New Zealand Therapeutic Products Agency.
Two years ago Prime Ministers Key and Gillard decided to renew efforts to establish a joint Australia/New Zealand scheme for the regulation of therapeutic products - pharmaceutical products and devices - under the Treaty signed in 2002. The scheme will be administered by the Australia New Zealand Therapeutics Products Agency, known to many of you as ANZTPA. It will become operational in mid-2016.
ANZTPA will be another key institutional milestone under Closer Economic Relations (CER) and will be the first joint regulator. It will replace the Therapeutic Goods Administration in Australia and Medsafe in New Zealand.
As you will appreciate, the establishment of a joint regulator presents some unique challenges to ensure both sides have "equivalent voice". The authority and power of ANZTPA will be derived from a joint Ministerial Council. Efforts are focused on, amongst other things, governance design, dealing with the interface between our respective administrative law regimes and how we go about joint enforcement.
Officials have also begun the process of drafting a full set of common regulations - to be known as 'Rules'.
These include Rules on medicines, devices, biologics, transitional arrangements etc. as well as administrative Rules. These Rules will be consulted with stakeholders in due course.
ANZTPA is a strategic initiative by both governments to ensure that Australia and New Zealand are positioned with a world class cost effective regulator which meets consumer needs and supports investor confidence. For New Zealand, the costs, complexity and skills required to run a stand-alone agency will become increasingly difficult.
The lessons learnt from this exercise will help pave the way for future institutional integration efforts under CER.
I would like to thank you again for inviting me to provide an update on medicines policy. As you have heard, a number of significant improvements have been achieved and more are coming. We all have an important role to play in driving the better use of medicines and pharmacy and achieving better integration in healthcare.
I would like to thank you for the positive contribution you have made, and will continue to make, to the well-being of New Zealanders.
I wish you all a very enjoyable conference.
Presentation of Value of Medicines Award I am now very pleased to present the annual Medicines New Zealand Value of Medicines Award.
The aim of the award is to support an outstanding piece of research that will improve the understanding, effectiveness or safety of medicine or vaccine use in New Zealand. The winning individual or research team receives $20,000.
This year’s winner is Dr Conroy Wong who is the Clinical Head of Respiratory Medicine at Middlemore Hospital, Respiratory physician and Honorary Senior Lecturer at the University of Auckland. Dr Wong led a study on the use of azithromycin as a treatment for bronchiectasis.
The study found for the first time that azithromycin is an effective treatment for bronchiectasis, a debilitating disorder with few evidence-based treatments. The study demonstrated that research on important but less common conditions can be carried out in New Zealand by cooperative research across a number research centres.
I would like to extend my personal congratulations to Dr Wong and his team.