Pharmac should plan better when switching brands

I FEEL for the people who have suffered deterioration in their depression following a switch of funded brand of an antidepressant by Pharmac (ODT, 3.9.18).

I experienced a similar problem that improved when I changed back to the venlafaxine I was stable on.

As a health professional who has an understanding of the Pharmac system, I was able to recognise the problem and fortunately pay the cost of the original brand myself, quite quickly.

It seems to me that although Pharmac’s NPPA process is available, the ‘‘exceptional’’ circumstances requirement and need to have tried all the funded alternatives first, does not fit well with the treatment of depression.

Many will know that people with depression can respond well to some medicines and not others, with no particular logic or predictability, and this takes time and stress for the person and their support network to work out. Meanwhile they are still struggling to function, as described by Ms Macrae.

The fact of a person’s depression deteriorating when brand funding is switched may not be exceptional, but for a small percentage of people on venlafaxine this has been their situation.

Can Pharmac not provide for this likelihood for a few people, rather than promoting the NPPA process ‘‘after the fact’’, which in 27 cases relating to venlafaxine was unsuccessful? Name withheld

Dunedin