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Making best use of medicines a key challenge

Media release Tuesday November 28, 2006

Making best use of medicines a key challenge – PHARMAC

PHARMAC is giving New Zealanders a “could do better” for the way they use medicine.

Figures released in PHARMAC’s 2006 Annual Review show that prescriptions for subsidised medicine have reached an all-time high of 28.5 million prescriptions, independent research indicates not all this medicine is being taken as intended.

“While there are good health gains to be made from investing in new medicines, there are potentially even greater gains to be made from properly using the medicines that are already subsidised,” Acting Chief Executive Matthew Brougham commented at the launch of PHARMAC’s 2006 Annual Review.

“Ensuring medicines are well used is one of the key challenges for the health sector in making sure people get the best from the treatments they are prescribed.”

Matthew Brougham describes the optimal use issue as one of PHARMAC’s three key future challenges, along with high cost medicines and raised public expectations.

2005/06 was a year when access to medicines grew significantly – 41 new investments were made in medicines, 14 new medicines were subsidised and prescription volumes grew to record levels.

However, independent research from the US-based Commonwealth Fund highlights that not all this medicine is being taken as intended. They found that, in New Zealand:

 annually, some 2.5 million prescriptions (9%) are dispensed incorrectly;
 around 50% of people do not take medicines as prescribed;
 around 50% of people do not receive a regular review of all medicines they take; and
 around 1/3rd of people do not usually get side-effects explained to them.

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“This information clearly suggests that significant health gains are being missed because of medicines not being used properly,” Matthew Brougham says.

“PHARMAC and other health sector agencies are undertaking innovative work to promote optimal use of medicines, but there is much more to be done. This is not about the level of money spent on drugs, it is about making whatever level we do spend go as far as possible.”

Matthew Brougham says ensuring that people make the best use of their medicines is a team effort, involving well-informed patients, pharmacists, prescribers, PHOs and other health agencies.

PHARMAC already takes steps to address this area, through its function to promote the responsible use of medicines (Demand Side). In some cases responsible use involves taking more medicine; in others it means taking less.

The One Heart Many Lives campaign, which is highlighted in the Annual Review, is an example of PHARMAC’s commitment to ensuring its budget is spent efficiently. That campaign encourages people, with their doctor’s support and alongside lifestyle improvements, to take medicine to reduce their risk of suffering a heart attack or stroke. On the other hand, the Wise Use of Antibiotics campaign has led to lower use.

“Optimal use” is also central to addressing disparities in the way New Zealanders use medicines. For example, Maori and Pacific people are more likely to depend on a short-acting asthma reliever (such as Ventolin), and less likely to use a long-acting reliever (like Serevent or Oxis) than European New Zealanders. However, Maori and Pacific people are up to two and a half times more likely to be admitted to hospital with asthma-related complications than European New Zealanders.

Access issues can also arise as a result of location, such as in rural areas where pharmacy access is more difficult. For example, while cholesterol-lowering statin use has increased, there continue to be large variations in the rates of prescribing across different regions. And similar to asthma patterns, there are lower statins prescribing rates for Maori and Pacific people than for European New Zealanders.

“Understanding these trends and access issues can only help in finding ways to address them, and in doing so promote better health for New Zealanders,” Matthew Brougham says.


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