Pharmaceuticals and public policy: Learning from the New Zealand experience

Abstract

Pharmaceuticals provide a useful analytical prism through which to view a wider range of policy issues in the health arena. The fundamental characteristics of pharmaceuticals are shared by many other health care items and raise important policy questions in five key institutional areas: the market, science, the State, the professions, and the public. In one way or another the key policy issues raised in each one of these areas concern fundamental questions of restraint and regulation: the ability of the market to exert the normal disciplines of price competition on pharmaceuticals; the extent to which the claims of intellectual property conflict with the norms of scientific advance; the reconciliation of the different functions of the State, particularly in the management of risk; the efficacy of traditional mechanisms of self-regulation and peer review in the health professions; and the implications of pharmaceuticals for broader questions of social control. These issues are illustrated from the recent experience of a country, New Zealand, that has undergone major deregulation and restructuring of State activities. Conclusions are drawn for policy development in the pharmaceuticals area.