I often quip that we are a Second World country when it comes to medical advances.
Take empaglifozin, for example, a breakthrough in diabetes treatment that was approved for medical use in the United States in 2014.
This drug was funded only last year in New Zealand and we are now prescribing it in spades.
We seem to lag behind many well-developed countries when it comes to innovative and improved treatments.
Cost is an important reason for this, but there is also the need for a precautionary approach ensuring an expensive treatment works well and is safe.
The decision to fund a medication in New Zealand rests with Te Pātaka Whaioranga (the health store), known as Pharmac, which first considers advice from the expert Pharmacology and Therapeutics Advisory Committee.
This makes sense because health resources are limited, even more so as we face the pandemic.
However, this is cold comfort to Troy Watson, who is waiting for this process to provide him access to Trikafta, so he can breathe and live fully. NZME reported on his situation in April.
I have patients who are paying thousands for life-prolonging cancer treatment, due to our parsimonious approach to funding medicine.
While Pharmac has done an amazing job of using the pharmaceutical budget most efficiently, in my view it sits in an inconsistent environment, creating inequity for our citizens.
Why do we have the utmost rigour when it comes to treatment, but engage in a less-disciplined approach to prevention?
Our annual tax take from the excise tax on alcohol, a known carcinogen, is about $2 billion.
We spend more than $7.85 billion a year on alcohol harm. On the face of it, in my view, this is poor business practice for a country to operate this way.
There is clear evidence that raising excise tax, and other measures, significantly reduce this harm.
If we apply the same business approach to this public health issue, we will surely raise excise tax, reduce accessibility and dismantle advertising, and then use the money saved towards essential needs such as the Pharmac budget.
In the present framework, we have barriers to people at their most vulnerable hour, but simultaneously our commercial environment encourages New Zealanders to overuse a toxic product that makes many of them sick.
About 824,000 people are risky drinking in this country, creating an enormous health burden, and Māori bear a greater proportion of this harm than non-Māori.
Alcohol is risky for any drinker, and five of us die weekly due to its cancerous effects.
Why have inadequate restrictions on advertising and availability of a carcinogen, but have significant restrictions on life-changing treatment for cancer?
Here is where I get angry. Concerned communities struggle to limit alcohol-related harm despite their best efforts.
Supermarkets have been given leave to appeal Auckland’s Local Alcohol Policy in the Supreme Court.
The Sale and Supply of Alcohol Act 2012 was supposed to have provided a mechanism for each region to develop its own local alcohol policy, giving the community a say on where and how many liquor outlets could be open.
Most local alcohol policies (LAPs) in this country have been legally appealed by large conglomerates and, in my view, very few LAPs are working to any substantial effect.
It is heartening to see the councils of Auckland and Christchurch throw their support behind Chlöe Swarbrick’s member’s bill, which seeks to remove the appeals process from LAPs and dismantle alcohol advertising in sport.
I believe there is public acceptance for sound policy change around alcohol, so we should get on with this before we waste more precious resources.
The Sale and Supply of Alcohol Act needs reviewing, and health cost-saving measures should apply to public health issues such as alcohol.
At present, in my view, the alcohol industry has us trumped, so let’s make our health system great again.