Friday, 27 March 2009

PHARMAC. Phucking Arseholes.

For those of you that don't know, PHARMAC are a bunch of bearded sages with residence in New Zealand's Wellington. Every so often , I have to deal with them. It's an unpleasant experience. Imagine trying to say to Daily Mail readers that asylum seekers should have medical treatment because, they're, you know, FUCKING HUMAN. ( I mean asylum seekers are human, Daily Mail readers are clustercunts of the highest order).

That's kind of what it's like dealing with PHARMAC.

Every so often, I have to submit something called a Hospital Exceptional Circumstances application to PHARMAC. This is essentially a form asking for a medication asking for permission to fund a treatment out of the hospital's own budget. For example, I would put in a form saying can I have benzbromarone to treat my gouty bloke please, and the aforementioned bearded sages would stroke their beards, along with other extremely small parts of their anatomy, and decree that yes, I was allowed to have benzbromarone, because it costs about tuppence, and it's cheaper than repeatedly hospitalising the bloke with gout attacks. So essentially it all comes down to money, and PHARMAC think that if supplying the drug for a year will be cheaper than the alternative (hospital treatment), then the drug will be supplied.

There's a couple of ways to get round this, namely

1) "Hey bro, my patient needs this medicine for a few more days, how can we do that?"

"Well, we could send him out on *WINK WINK NUDGE NUDGE* leave for a few days ,so long as he's still being reviewed by you guys *WINK WINK NUDGE NUDGE*

2) Creativity/Lies. Or basically every single Clexane application, ever.

My part in this tends to be saying to the applying doctor "Look, bro, your patient had a bad reaction to warfarin in the past, remember, that really really big bleed or allergic reaction? It would be really useful if you could remember that? Remember? Oh, and by the way, phenindione is a fucking shithouse drug that kills people, so your patient can't have that either. Do you understand what I'm saying?" So it's a bit like being self-employed and having a conversation with your accountant.

So, PHARMAC, in your infinite wisdom, can a 17 year old girl have a drug that will stop her going into renal failure and requiring permanent dialysis?

"No, we are not convinced it's cost-effective, as she hasn't gone into renal failure yet. Come back to us when she has gone into renal failure. Have you tried phenindione?"

So there we are. This shit-for-brains government organisation think that you're not allowed a drug to stop you from dying because it's to expensive, until you actually start dying, by which time it's too late. Quality of life means nothing to them. Fucking wankers. I hope they can all afford to pay for their own medical treatment. Wankers.

78 comments:

Anonymous said...

As always, I'm fascinated by the English lingo as spoken from those out of the US. It sounds as if PHARMAC is the deciding group for the hospital formulary service in UK, or your neck of the woods. Don't they have clinical pharmacists on their Boards, or are they all a bunch of penny-pinching accountants?

However, with regard to pharmacology, here in US, we seem to be more into efficacious enoxaparin and warfarin than phenindione (do you mean 2-phenyl-1H-indene-1,3(2H)-dione) or phencoumarin. Heck, I studied those agents in med chem 25 years ago listed as alternative anticoagulants, but don't even see those vitamin K antagonists listed in Facts & Comparisons any more.

The standard of care here (even in government institutions) includes anti-platelets, heparins, and leech derivatives e.g. bivalrudin for those allergic to above.

Pharmacy Applicant Student Database said...

Is this what you guys deal with over across the pond? I don't know who has it better or worse.

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