Exploring the implications of a fixed budget for new medicines: a study of reimbursement of new medicines in Australia and New Zealand

2015 ◽  
Vol 39 (4) ◽  
pp. 455 ◽  
Author(s):  
Colman Taylor ◽  
Michael Wonder
Keyword(s):  
New Zealand ◽  
Federal Government ◽  
Access To Medicines ◽  
Policy Makers ◽  
Independent Entity ◽  
The Government ◽  
Government Health Expenditure ◽  
Good Policy ◽  
Available Information ◽  
Published Research

Objective Spending on medicines under the Pharmaceutical Benefits Scheme (PBS) represents the ninth largest expense to the Federal Government. A recent report by the Commission of Audit to the Federal Government suggested spending on the PBS is unsustainable and a capped budget, similar to New Zealand’s PHARMAC model, may be required to contain costs. The objective of the present study was to compare listing outcomes between Australia and New Zealand, thereby exploring the opportunity cost of a capped budget for new medicines. Methods Listing outcomes in Australia and New Zealand were compared through published research and an updated search of listing outcomes from publicly available information. Results Previous research has demonstrated that New Zealand listed less than half of the new medicines listed in Australia over a 10-year period (2000–09). Our research shows that most of the new medicines not listed in New Zealand during this period remain unlisted today. In the previous 12 months, Australia listed 17 new medicines on the PBS, whereas New Zealand listed only one new medicine that was not already listed in Australia. Conclusion The discrepancy in the number of new medicines listed in New Zealand compared with Australia raises questions regarding the consequences of implementing a capped budget for new medicines. However, further research is needed to understand the relationship between listing outcomes, access to medicines and health benefits for the community. What is known about this topic? Due to factors such as an aging population and longer life expectancy, total government health expenditure as a proportion of gross domestic product (GDP) is expected to rise. Consequently, many commentators have suggested current expenditure patterns are unsustainable. The PBS represents a significant expense to the government and recent reports suggest the PBS should be reformed to align with New Zealand’s PHARMAC model, where an independent entity manages access to subsidised medicines under a capped budget. However, little information exists regarding access indices for new medicines in New Zealand compared with Australia. What does this paper add? This paper builds on previously published research comparing listing outcomes for new medicines in Australia and New Zealand. The results highlight a discrepancy in listing new medicines in New Zealand compared with Australia that has not improved in recent years. Consequently, the results question the notion that a capped budget for new medicines is a good policy choice for Australia. What are the implications for practitioners? This paper reviews the current reimbursement system in Australia and compares it with New Zealand’s PHARMAC model. In addition, this paper compares listing outcomes for new medicines in Australia and New Zealand. In doing so, the results of this paper have implications for practitioners who are concerned about continued subsidised access to new medicines via the PBS, and for policy makers in relation to proposed PBS reforms. Further, our paper provides insights into PBS policy reform that may assist practitioners who are interested in commenting on any proposed reform.

scholarly journals Safeguarding seeds and Maori intellectual property through partnership

2016 ◽  
pp. 1-9
Author(s):  
Sue Scheele
Keyword(s):  
New Zealand ◽  
Cultural Knowledge ◽  
Policy Makers ◽  
Biological Resources ◽  
Knowledge Culture ◽  
Treaty Of Waitangi ◽  
Core Concepts ◽  
The Government ◽  
Domestic Affairs ◽  
Waitangi Tribunal

The Nagoya Protocol is a recent binding international instrument that articulates the need to recognise the rights of indigenous peoples regarding their biological resources and cultural knowledge and strengthens the mechanisms to do so. New Zealand has not signed this protocol because of the overriding importance of the Treaty of Waitangi in New Zealand’s domestic affairs, and the need to ensure that government options are not limited concerning the development of domestic policy on access to biological resources. In particular, policy makers and legislators are waiting for the government response to a 2011 Waitangi Tribunal report (Ko Aotearoa Tēnei) on a far-reaching and complex claim (WAI 262) concerning the place of Māori traditional knowledge, culture and identity in contemporary New Zealand law and government policies and practice. Especially pertinent to this paper is the report’s section on Māori rights relating to biological and genetic resources. In accordance with the recommendation within Ko Aotearoa Tēnei, the principle of partnership, built on the explicit Treaty premise of Crown and Māori as formal equals, is presented here as the overarching framework and mechanism by which government agencies and Māori can work together to safeguard such resources. Core concepts and values are elucidated that underpin the Māori relationship to indigenous flora and fauna and are integral to the protection of cultural knowledge of seeds and plants. Examples are given of plant species regarded as taonga (treasures) and how they are conserved, and a case study is presented of institutional stewardship of harakeke (New Zealand flax) weaving varieties. Seed bank facilities are also evaluated regarding their incorporation of Māori values and rights under the Treaty of Waitangi.

scholarly journals Women In Paid Employment – The Care Factor

2015 ◽  
Author(s):  
Suzy Morrissey
Keyword(s):  
New Zealand ◽  
Government Support ◽  
Future Research ◽  
Limited Participation ◽  
Policy Makers ◽  
Broad Perspective ◽  
Paid Employment ◽  
Part Time ◽  
The Government ◽  
The Cost

63.7% of women are now in some form of paid employment in New Zealand, which is in line with the OECD average of 65%. However, of those women, approximately a third in part-time paid employment and women make up over two-thirds of all part-time workers.One of the most cited reasons for women’s limited participation in, or absence from, the labour market is the cost and availability of childcare. In New Zealand, as in many other countries, mothers still undertake the vast majority of care for children. This paper examines the childcare situation in New Zealand. Taking a broad perspective of what is captured by the term ‘childcare’, it outlines the various types of government support currently provided to children up to age 13, and summarises the total cost of funding.The purpose of the paper is to collate information about the range of services provided by the government which incorporate an element of care. This information can be analysed by academics and policy makers to determine whether the services currently provided are efficient and effective, and meets the needs of parents.The paper also raises two issues for further consideration, which it does not address itself. Firstly, the various mechanisms for government support, in terms of demand-led and supply-side funding, and whether they should be targeted or universal. Secondly, the types of childcare which are not government funded – the informal childcare provided by family, particularly grandparents and older siblings, and friends. These areas may be of relevant future research, particularly if change to the current situation is desired.

KEBIJAKAN POLITIK KERUKUNAN ANTARAGAMA DI INDONESIA ERA REFORMASI

2017 ◽  
Vol 9 (2) ◽  
pp. 407-424
Author(s):  
Jamaluddin Jamaluddin
Keyword(s):  
Transition Period ◽  
Religious Life ◽  
New Order ◽  
Reform Era ◽  
Policy Makers ◽  
Accommodation Space ◽  
Nation States ◽  
The Government ◽  
Definition Of ◽  
Cultural Reality

Indonesian reformation era begins with the fall of President Suharto. Political transition and democratic transition impact in the religious life. Therefore, understandably, when the politic transition is not yet fully reflects the idealized conditions. In addition to the old paradigm that is still attached to the brain of policy makers, various policies to mirror the complexity of stuttering ruler to answer the challenges of religious life. This challenge cannot be separated from the hegemonic legacy of the past, including the politicization of SARA. Hegemony that took place during the New Order period, adversely affected the subsequent transition period. It seems among other things, with airings various conflicts nuances SARA previously muted, forced repressive. SARA issues arise as a result of the narrowing of the accommodation space of the nation state during the New Order regime. The New Order regime has reduced the definition of nation-states is only part of a group of people loyal to the government to deny the diversity of socio-cultural reality in it. To handle the inheritance, every regime in the reform era responds with a pattern and a different approach. It must be realized, that the post-reform era, Indonesia has had four changes of government. The leaders of every regime in the reform era have a different background and thus also have a vision that is different in treating the problem of racial intolerance, particularly against religious aspect. This treatment causes the accomplishment difference each different regimes of dealing with the diversity of race, religion and class that has become the hallmark of Indonesian society.

Intra-sectoral and Intersectoral Parity Issues in Pricing of Agricultural Crops: A Preliminary Analysis

1987 ◽  
Vol 26 (4) ◽  
pp. 401-417
Author(s):  
Sarfraz K. Qureshi
Keyword(s):  
Preliminary Analysis ◽  
Agricultural Sector ◽  
Terms Of Trade ◽  
Agricultural Crops ◽  
Allocation Of Resources ◽  
Price Determination ◽  
Policy Makers ◽  
The Government ◽  
Distribution Of Income ◽  
Over Time

Intersectoral terms of trade play a cruc1al role in determining the sectoral distribution of income and resource allocation in the developing countries. The significance of intra-sectoral terms of trade for the allocation of resources within the agricultural sector is also widely accepted by research scholars and policy-makers. In the context of planned development, the government specifies production targets for the agricultural sector and for different crops. The intervention of government in the field of price determination has important implications for the achievement of planned targets. In Pakistan, there is a feeling among many groups including farmers and politicians with a rural background that prices of agricultural crops have not kept their parities intact over time and that prices generally do not cover the costs of production. The feeling that production incentives for agriculture have been eroded is especially strong for the period since the early 1970s. It is argued that strong inflationary pressures supported by a policy of withdrawal of government subsidies on agricultural inputs have resulted in rapid increases in the prices paid by agriculturists and that increases in the prices received by farmers were not enough to compensate them for the rising prices of agricultural inputs and consumption goods.

scholarly journals An Investigation of the Socio-Economic Benefits of Small-Scale Gold Mining in Malawi

Mining ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 19-34
Author(s):  
Tiyamike Haundi ◽  
Gift Tsokonombwe ◽  
Steven Ghambi ◽  
Theresa Mkandawire ◽  
Ansley Kasambara
Keyword(s):  
Gold Mining ◽  
Indigenous Communities ◽  
Economic Benefits ◽  
Gold Rush ◽  
Basic Knowledge ◽  
Small Scale ◽  
Low Literacy ◽  
Policy Makers ◽  
Key Stakeholders ◽  
The Government

In the recent years, there has been a surge in artisanal and small-scale gold mining (ASGM) in various districts of Malawi. Reports of a gold rush have emerged in various districts, including Mangochi, Lilongwe, Balaka, and lately in Kasungu. There has been persistence by many indigenous communities participating in ASGM activities, yet little is being done by the government to formalize and support the sub-sector. The purpose of this study was to investigate the benefits of artisanal small-scale gold mining in Malawi and expose the shortfalls so that key stakeholders and policy makers are well informed. A quantitative approach which used semi-structured questionnaires was used and the data was analyzed using Microsoft excel and Statistical Packages for the Social Sciences (SPSS). The study shows that ASGM is characterized by people with low literacy levels, who use traditional tools (low-tech) and use methods fueled by lack of capital, and deficiency of basic knowledge of mining and geology. The study found that the government could achieve substantial socio-economic development from the sector by: (1) revising the current artisanal and small-scale mining (ASM) legislation so that it embraces the customary practices whilst safeguarding the environment and improving the tax collection base; (2) providing support in form of mining related training and education to these communities; (3) leading in transfer of modern technologies for improved extraction; (4) supporting ASM cooperatives in securing credit facilities from financial institutions; and (5) closing the existing knowledge gap for ASM related issues through introduction of mining desk officers in district councils.

scholarly journals Public Response, Anxiety and Behaviour during the First Wave of COVID-19 Pandemic in Saudi Arabia

2021 ◽  
Vol 18 (9) ◽  
pp. 4628
Author(s):  
Amani Salem Alqahtani ◽  
Meshael Mohammed Alrasheed ◽  
Ada Mohammed Alqunaibet
Keyword(s):  
Cross Sectional ◽  
Protective Measures ◽  
Policy Makers ◽  
Factors Affecting ◽  
Public Response ◽  
Social Events ◽  
Phone Survey ◽  
Younger Age ◽  
Low Levels ◽  
The Government

This study aims to investigate public response attitude, anxiety, practices and trust in the authorities’ mitigation plan during the first wave of COVID-19 pandemic. A national cross sectional phone survey was conducted among Saudi residents aged 16 years and above. A total of 90,421 (45.2%) individuals participated in the study. Of those, the overall rate of COVID-19 correct knowledge was 82% (mean: 9.84); social media was the most reported source of knowledge. Younger age, low levels of education and foreign residents were associated with poor knowledge. Overall, 49.5% scored 5 or more on the GAD-7 test, indicating anxiety symptoms, 19.2% of them scored 10 and above, suggesting moderate to severe anxiety. Majority of participants (>78%) trusted and supported the interventions implemented by the government to control COVID-19. Social distancing practices among participants was as following, 72.5% stayed at home and avoid going out for nonessential business and 49.5% avoided attending social events and family gatherings. Trust in authorities, being anxious, worry and levels of knowledge about the disease, were the most common factors affecting adoption of the recommended practices. Continuous evaluation of public response about COVID-19, and the effectiveness of protective measures is essential to better inform policy-makers and identify ways of encouraging behaviour change among public during pandemic.

scholarly journals Perspectives of pharmaceutical stakeholders on determinants of medicines accessibility at the primary care level

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Hoda Ibrahim Rizk ◽  
Monira Mahmoud Elkholy ◽  
Abeer Abdou Barakat ◽  
Raghda Mostafa Mostafa Elsayed ◽  
Shaimaa A. M. Abd El Fatah
Keyword(s):  
Health System ◽  
Access To Medicines ◽  
Generic Medicine ◽  
Essential Medicines ◽  
Cross Sectional ◽  
Urban Group ◽  
Rural And Urban ◽  
External Stakeholders ◽  
Assessment Approach ◽  
The Government

Abstract Background Equitable access to essential medicines of maintained efficacy, safety, quality, and cost-effectiveness must be ensured by a well-functioning health system. This study aims to identify the determinants of patients’ access to medicines at the primary health care (PHC) level from the perspectives of various (internal and external) stakeholders of the pharmaceutical system. Methods The study employed both quantitative and qualitative components. Quantitative component applied a descriptive a cross-sectional design and qualitative component applied an in-depth interview design. It was a health system research conducted at two (PHC) facilities (one urban and the other rural) in Egypt. It inquired upon political, economic, and managerial aspects of the pharmaceutical system utilizing the “Health System Assessment Approach: a How-To Manual” and the “WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations.” Results Analysis of the quantitative data extracted from the cross-sectional component with external stakeholders (patients) revealed that about one-third of patients in both facilities were unable to pay for the medicine. Patients in both settings took less than an hour to reach the PHC facility. The Percent of patients who believe that the private pharmacies’ medicine is better than the PHC one was significantly higher in rural than urban group (24% and 10% respectively) and the percent of medicines dispensed was 50% and 66.7% in rural and urban groups respectively. Analysis of the qualitative data extracted from in-depth interviews with internal stakeholders (key informants from regulatory agencies, pharmaceutical industry, academia, pharmacists, and physicians) were summarized utilizing Strengths-Weaknesses-Opportunities-Challenges (SWOC) analysis approach. Various viewpoints toward the determinants of patients’ access to medicines were disclosed. Conclusions The Percent of medicines dispensed was insufficient in both rural and urban facilities. There is a need to invest in building trust in generic medicine quality in the government health facilities focusing on improving medicine availability and ensuring enough amounts of high-quality drugs. Although there are drug committees in the two studied PHC facilities for demonstrating the prescribing and dispensing policies, yet the system required to enforce these policies is still deficient.

Socio economic and psychological dimensions of migration-induced exclusion of the elderly in Kerala, India: an empirical analysis

2016 ◽  
Vol 12 (1) ◽  
pp. 51-65
Author(s):  
Damodaran Rajasenan ◽  
M. S. Jayakumar ◽  
Bijith George Abraham
Keyword(s):  
The Elderly ◽  
Policy Framework ◽  
Policy Makers ◽  
Content Type ◽  
Left Behind ◽  
Emerging Culture ◽  
Principal Factors ◽  
Working Groups ◽  
The Government ◽  
Role Of The Government

Purpose – The purpose of this paper is to link the multifarious problems of the elderly in a socio-economic and psychological framework. Design/methodology/approach – The universe of the sample is elderly left behind in emigrant households in Kerala. In total, 600 samples were mustered using multistage stratified random sampling method. The paper, with the aid of factor analysis, χ2 and correspondence analysis, blemish the principal factors responsible for the migration-induced exclusion of the elderly. Findings – The empirical result derived from the study shows that migration-induced exclusion is all pervasive in Kerala. The elderly left behind yearn for the presence of their children rather than the emigration and concomitant remittances. Research limitations/implications – The findings of the study are helpful to the policy makers to understand the issues faced by the elderly and include all stakeholders concerned to find a solution to tackle these problems faced by the elderly due to emigration of their children. Practical implications – The study is practically relevant in developing appropriate policy framework in Kerala as it illumines the role of the government to overcome the exclusionary trend and other manifold problems of the elderly. Social implications – The study sheds light to a new social problem developing in the state in the form of elderly exclusion owing to emigration of the young working groups in regional dimensions, demographic levels, community angles and the emerging culture of old age home in the Kerala economy and society. Originality/value – The study is a unique one and tries to situate the principal factors responsible for the emigration-induced exclusion of the elderly in Kerala with empirical evidence.

Clivage linguistique et vote économique au Canada

1998 ◽  
Vol 31 (3) ◽  
pp. 557-572 ◽  
Author(s):  
Daniel Guérin ◽  
Richard Nadeau
Keyword(s):  
Federal Government ◽  
Economic Voting ◽  
Liberal Party ◽  
Electoral Outcomes ◽  
Electoral Impact ◽  
The Government ◽  
Established Democracies ◽  
Economic Perceptions

AbstractThis study deals with the question of economic voting in Canada, notably that the electoral impact of economic perceptions with regard to the performance of the federal government has not been homogeneous among the whole Canadian electorate during the period of Liberal dominance in Quebec. Contrary to our Findings on voters in other provinces, francophone Quebeckers did not vote according to their judgment of the government on economic matters, their fidelity to the Liberal party having inhibited them in this respect. These results suggest that the absence of economic voting in Quebec during the Liberal regime may clarify, at least in part, the puzzling conclusions of previous research, that show a fragile relationship between the economy and the electoral outcomes in Canada. These findings break new ground for a better understanding of the specific electoral rationality used by minorities in long-established democracies.

Intervention by Outsiders: A Strategic Management Perspective on Government Industrial Policy

1993 ◽  
Vol 13 (1) ◽  
pp. 69-88 ◽  
Author(s):  
Romano Dyerson ◽  
Frank Mueller
Keyword(s):  
Public Policy ◽  
Strategic Management ◽  
Industrial Policy ◽  
Financial Control ◽  
Firm Level ◽  
Policy Makers ◽  
Management Perspective ◽  
British Experience ◽  
The Government

ABSTRACTAs the debate throughout the eighties has concluded, the efforts of governments to intervene at the firm level has largely been disappointing. Using two examples drawn from the British experience, Rover and Inmos, this paper offers an analysis as to why the Government has encountered difficulties when it has sought to intervene in a strategic fashion. Essentially, public policy makers lack adequate mechanisms to intervene effectively in technology-based companies. Locked out of the knowledge base of the firm, inappropriate financial control is imposed which reinforces the ‘outsider’ status of the Government. Having addressed the limitations of strategic intervention, the paper, drawing on the comparative experience of other countries, then goes on to address how this policy boundary might be pushed back in the long term.

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