We think that transparency, or lack of transparency, is a significant issue. That happens at a number of different levels. The area that we are most concerned about is that in the best practices of a health technology assistance system, you wouldn't have your advisory committee as part of the pharmacare system. It should be independent and stand outside of that, but in New Zealand it doesn't. It's all part of the same organization.
The committee is operated by Pharmac. It makes recommendations to the board, so they're making recommendations to themselves, basically. We think that is problematic. There is a lack of transparency. As Graeme described before, we don't know how their assessments are made. We speak often to Pharmac and ask for explanations, but they're very reluctant to shed any light on how they go about making those decisions.
Given that low-priority medicines are often funded ahead of high-priority medicines that might be more expensive, the conclusion we often come to is that these decisions are made on financial grounds rather than on quality scientific grounds.