Concern that district health boards do not have control over pharmaceutical spending has been expressed by Otago District Health Board member and pharmacist Peter Barron.
Pharmaceuticals represented about 12% of the Otago board's budget and, although Pharmac did consult boards when setting annual budgets for prescription medications nationally, boards effectively ceded decision-making on this.
This was particularly difficult if boards were not consulted until late in their planning process for the district annual plan process.
He suggested Pharmac could be funded directly.
Board chief executive Brian Rousseau said Pharmac did not hold funding. It negotiated with pharmaceutical companies to set the price to be paid for prescription medicines. If low prices were negotiated, more money could be spent subsidising medications.
Boards held funding because each board paid government subsidies on prescriptions people filled at pharmacies in its area. The total paid depended on the number of prescriptions.
Pharmac estimated how much subsidised medications would cost each year and it did listen when boards advised they could not afford what was sought.
This had happened recently.
Mr Rousseau acknowledged consultation had been later than normal because of debate over health boards' funding. There had been much negotiation leading to a decision which was one Otago could afford, he said.
Board chairman Richard Thomson said Mr Barron's suggestion would remove flexibility.
If a board managed its population's health so it required less expenditure on medications then it could use money not required for subsidised prescriptions for other things.
That would not happen if Pharmac held the funding. The system might not be perfect, but it was the " least worst" one available.
