New leadership for the troubled NPS MedicineWise gives the organisation an opportunity to publicly acknowledge its serious failings and move ahead.
The organisation, which has announced the appointment of new CEO Katherine Burchfield, has repeatedly refused to answer questions or even publicly acknowledge the scathing findings of the review led by former PBAC chair Professor Lloyd Sansom AO.
That the review delivered a scathing final report is not in question. It was a remarkable and unusually brutal assessment of an organisation's feckless performance.
The review criticised NPS MedicineWise for a range of issues including a lack of transparency and accountability. It also highlighted the loss of stakeholder confidence in its stewardship of the quality use of medicines arm of the National Medicines Policy, which was the reason for its creation, and its excessive focus on the delivery of savings at the expense of public health outcomes.
How did the organisation respond?
It almost immediately accepted $8 million from the government to deliver $55 million in savings by reducing the use of PBS-listed bDMARDS.
We should not be surprised the government provided this funding. It goes against the 'Sansom' review recommendations but it was the one outcome the government obfuscated on accepting. In other words, the government gives every indication of seeing this organisation as the deliverer of savings rather than the promoter of the quality use of medicines.
NPS MedicineWise is achieving this saving for the government by systematically 'astroturfing' stakeholder groups through the so-called Targeted Therapies Alliance and promoting resources that advertise old and cheap products.
NPS MedicineWise has refused to answer questions on how much it is paying these groups to associate themselves with what is just a budgeted savings measure.
The alliance's resources fail to acknowledge the existence of reimbursed bDMARDS. It has even promoted the unproven 'nocebo' effect to encourage the uptake of biosimilars. Its references to support its claims on the 'nocebo' effect acknowledge there is no evidence of its existence.
So, how is it going on transparency, accountability, its stewardship of the quality use of medicines arm of the National Medicines Policy and prioritising public health outcomes over savings?
Ms Burchfield will also take the reins of an organisation that was found to have misused taxpayer funds to resource its commercial operation, VentureWise.
It has used lawyers to argue against the release of documents it provided to the 'Sansom' review. In other words, it has used taxpayer funds to argue against the release of documents about its misuse of taxpayer funds.
NPS MedicineWise quietly shut down its commercial operation, VentureWise, without acknowledging the decision had anything to do with the review that found its very existence undermined its reputation and was being improperly resourced by the government's Quality Use of Medicines Education grant. It was even the subject of an audit by KPMG.
It does not end there.
Since 2011, the federal government has committed over $33 million to the development of MedicineInsight as a mechanism to improve the post-market surveillance of medicines.
NPS MedicineWise administers MedicineInsight on behalf of the government and collects linked but de-identified data on patient diagnosis, prescriptions and clinical indicators.
Of course, the government has paid for the collection of this data, but NPS MedicineWise thought it would be appropriate to repackage and sell it as a commercial product. The 'Sansom' review delivered a damning assessment of this decision.
Yet, despite all this, the organisation has consistently refused to acknowledge its failings or even answer specific questions.
It is a case study on how not to respond to criticism and taxpayer-funded organisations that effectively operate as an arm of the federal bureaucracy do not get to avoid scrutiny.
The appointment of Ms Burchfield might be an opportunity for the organisation to do away with the unprofessional, 'undergraduate' and indefensible approach to scrutiny and finally acknowledge the failings that led to the scathing findings of the Sansom review, the loss of its leadership and most of its board, as well as many of its activities.
Ms Burchfield can enable the organisation to properly cleanse itself and start again by acknowledging its failings. It would empower the organisation to move ahead because one finding of the 'Sansom' review is that it does have an important role in ensuring the appropriate use of medicines. It just needs to be done properly.
Clearly, the Department of Health has just as many questions to answer, particularly given its decision to effectively hide the 'Sansom' review report, its handling of related freedom of information requests and its apparent insistence on NPS MedicineWise retaining its focus on the delivery of savings over public health outcomes.
The department has protected NPS MedicineWise by unlawfully refusing to release documents related to the 'Sansom' review. Actually, it is is probably protecting itself given the obvious failings in its oversight of the organisation.
In the 2018-19 Budget, the government remarkably announced it would renew its contract with NPS MedicineWise before it even launched Professor Sansom's review.
It was bizarre but it seems the decision was to carry on regardless of the review outcome. A review after two decades and half a billion dollars was probably a matter of course but you wonder whether departmental officials regret 'lifting the rock' on this organisation because what it revealed was so atrocious.
