Elsevier

Health Policy

Volume 112, Issue 3, October 2013, Pages 227-233
Health Policy

How the Trans Pacific Partnership Agreement could undermine PHARMAC and threaten access to affordable medicines and health equity in New Zealand☆☆

https://doi.org/10.1016/j.healthpol.2013.07.021Get rights and content
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Abstract

New Zealand's Pharmaceutical Management Agency (PHARMAC) has been highly successful in facilitating affordable access to medicines through a combination of aggressive price negotiations, innovative procurement mechanisms, and careful evaluation of value for money. Recently the US government, through the establishment of a series of bilateral and plurilateral “free” trade agreements, has attempted to constrain the pharmaceutical access programs of other countries in order to promote the interests of the pharmaceutical industry. The Trans Pacific Partnership Agreement (TPPA) represents the latest example; through the TPPA the US is seeking to eliminate therapeutic reference pricing, introduce appeals processes for pharmaceutical companies to challenge formulary listing and pricing decisions, and introduce onerous disclosure and “transparency” provisions that facilitate industry involvement in decision-making around coverage and pricing of medicines (and medical devices). This paper argues that the US agenda, if successfully prosecuted, would be likely to increase costs and reduce access to affordable medicines for New Zealanders. This would in turn be likely to exacerbate known inequities in access to medicines and thus disproportionately affect disadvantaged population groups, including Māori and Pacific peoples.

Keywords

Pharmaceutical coverage programs
Access to medicines
Trade agreements
Health equity

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In the earliest version of this article as an article in press, the author's disclaimer was missing from the composed article due to a composition error. The disclaimer was provided by the authors prior to publication and its omission from the article in press was the responsibility of the journal.