PHARMAC and lack of funding for clopidogrel.
Clopidogrel is an antiplatelet drug that has been shown in several trials to reduce clinical events such as cardiovascular death, stroke, and myocardial infarction when compared to aspirin in a broad range of patients with atherosclerotic vascular disease. Clopidogrel has also been shown to reduce the same events by 20% when added to aspirin in patients with unstable angina and also in patients undergoing coronary artery stenting. Despite this information being available for 5 to 10 years, guideline recommendations, and the knowledge that 5% of patients have major allergy to aspirin, New Zealand patients have only been able to receive funded clopidogrel for a short period, typically 3 weeks, after coronary artery stenting. We believe this is an example where New Zealanders have been denied treatments, despite a strong evidence-base, by PHARMAC's actions of delaying the funding of new drugs. We need to have a better process whereby New Zealanders can rapidly access new treatments.
White
Harvey
H
Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. harveyw@adhb.govt.nz
Ellis
Chris
C
D000077144:Clopidogrel; D003362:Cost-Benefit Analysis; D004341:Drug Evaluation; D033161:Government Regulation; D006801:Humans; D009313:National Health Programs / Q000191:economics*; D009520:New Zealand; D010975:Platelet Aggregation Inhibitors / Q000191:economics*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000191:economics
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine