An unintended consequence of a recent decision imposed on the state drug purchasing agency Pharmac underscores the importance for New Zealand of establishing the capacity and capacity to produce its own drugs. The aim would be to reduce our dependence on international pharmaceutical companies often called “Big Pharma”.
Pharmac was forced to change funding for the antiepileptic drug primidone currently supplied by Apotex. As a result, and rightly so, it opened a public consultation on its proposal to switch to a new supplier, Teva. Primidone is classified as a “category one” drug. About 800 patients are affected.
Changing providers for drugs in this category is considered high risk. This is, however, different from the controversy that arose following Pharmac’s decision in 2019 to rebrand to an epilepsy drug. It was at the initiative of Pharmac.
In this recent case, however, Pharmac had no choice due to a shift in marketing focus from Apotex, a Canadian pharmaceutical company. Apotex decided there was more opportunity to maximize profits by divesting in a small country like New Zealand and focusing on the much larger North American market.
His decision to withdraw from New Zealand was taken in June 2019 and Pharmac has given way to other arrangements by the end of this year. From a business perspective, Apotex seems to have made a sensible decision. But for a public health system providing a universal public good, it was bad.
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In response, Pharmac entered into a tentative deal to supply primidone to Teva Pharmaceuticals, which is headquartered in Israel, but also has bases (and investment options) in the largest markets in the United States, from Europe and South America.
The next step is for Teva to apply for approval with the New Zealand Medicines and Medical Devices Safety Authority (Medsafe). Medsafe is the medical regulatory body managed by the Department of Health. He is responsible for the enforcement of the Medicines Act 1981 and the Medicines Regulations 1984.
But, to ensure there won’t be a shortage of supplies starting in December, Teva will supply Pharmac’s primidone as an unapproved drug in anticipation of Medsafe’s approval. It all depends on what might come out of the public consultation process.
From difficult situation to opportunity
This is not a good situation, but it was forced on Pharmac who answered correctly. This is a supply problem caused by the environment in which Pharmac has to work with a drug supply dependent on “Big Pharma”.
But this experience raises the question of whether New Zealand should begin to develop a long-term strategy to become independent of Big Pharma control over drug production. Pharmac’s problem was a direct result of our vulnerability to the changing market priorities of foreign pharmaceutical companies.
In an article published by the Democracy Project earlier this month, I advocated New Zealand’s value in learning from Cuba’s success in vaccine manufacturing, including recent encouraging developments in the Covid-19 vaccination: https: // democracyproject .nz / 2021/06/16 / geoffrey-miller-worst-could-be-still-to-come-for-perceptions-of-New Zealand-China /.
The development of a vaccine in Cuba was achieved by investing in various state biotechnology institutions, including their scientists, working collaboratively. This means that the development of a vaccine in Cuba can be achieved independently of the control of “Big Pharma” and is not profit oriented.
The same argument applies to drugs in which Cuba has also done well. Although more than double New Zealand’s population, Cuba is still a small country. More significant is the fact that it did so well despite 60 years of economic warfare by its hostile neighbor, the United States, which has intensified since 2016.
As noted by Royal New Zealand College of General Practitioners Medical Director Dr Bryan Betty, New Zealand already manufactures animal vaccines and therefore should be able to move towards our own production of human vaccines. New Zealand scientists are rightly held in high esteem, including internationally.
I’m saying that should extend to manufacturing pharmaceuticals for our health care system. These drugs should be seen as a universal public good because they are essential for the treatment and well-being of so many patients. The quality and profitability of our healthcare system depend on it.
The government should take the lead and develop a strategy for a state-led, state-supplied pharmaceutical manufacturing sector that first reduces and then hopefully removes our vulnerability to the shifting profit maximization priorities of ‘Big Pharma’ .
To enable this strategy, let’s use the country’s quality scientists for this purpose and invest more in their capacities and capacities. Cuba has done it; New Zealand too.
Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the trade union representing senior physicians and dentists in New Zealand, for over 30 years, until December 2019. He is now a health systems specialist , labor market, and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published in Otaihanga Second Opinion.