What happens when Pharmac doesn’t cover it?

There has been plenty of buzz in the media about Pharmac and unfunded cancer drugs – but what is it all about?

Read on for an outline of what Pharmac is, and how it works with our public healthcare system. And most importantly, what you can do to get affordable access to those treatments, whether they are publicly funded or not…

What is Pharmac and how does it work?

As you may know, Pharmac is a government agency that is responsible for deciding which medicines, vaccines and other treatments will be publicly funded in New Zealand. They also assess the continued performance of currently-funded pharmaceuticals. The agency has a finite budget every year, so its decisions are based on the recommendations of sub-committees and the results of clinical trials.

Unfortunately, this limited budget means that many potentially life-saving or life-extending drugs are not presently being funded, adding a financial burden to the emotional strain.

What does this mean for Kiwis?

Some ‘protest’ action has seen important treatments like Keytruda and Herceptin receive funding, but generally speaking, it’s best not to rely on Pharmac being able to amend its approved schedule – especially not at short notice.

We never plan on falling ill, but life has a way of making its own plans sometimes. If you find yourself in need of life-saving medication, but Pharmac doesn’t fund it, the alternative is to privately pay the costs of obtaining the treatment – often reaching thousands of dollars each month. For many New Zealanders, this just isn’t viable.

What can we do?

A good way to avoid possible heartache in the future is to sort out your ‘safety net’ today – the most effective of which is Health Insurance.

This Insurance type gives you the much-needed option of having private specialist/diagnostic treatments for an illness or condition, avoiding public hospital waiting lists. Plus, something you may not know, certain policies also cover the cost of non-Pharmac funded medicines.

This is a very important thing to consider when taking out Health cover. What would you do if you had to pay for treatment? And if you couldn’t afford it, could you afford to wait? This is where the right Health Insurance policy can make all the difference.

Remember: not all Insurance policies are equal, so if you’d like to talk about your needs and options, please get in touch. Finding the right cover could mean receiving the treatments you need when you need them, without the added worry of where the money is going to come from.

 

 

Disclaimer: Please note that the content provided in this article is intended as an overview and as general information only. While care is taken to ensure accuracy and reliability, the information provided is subject to continuous change and may not reflect current development or address your situation. Before making any decisions based on the information provided in this article, please use your discretion and seek advice from a financial adviser.