A patient-led installation called the Forbidden Pharmacy opens at Auckland’s Shed 10 on Saturday, lining its walls with shelves of white medicine packets and bottles locked behind doors. Each item stands for a treatment New Zealanders can be prescribed but cannot get paid for, and the point of the display is to turn a dry funding argument into something people can walk up to and stand in front of.
More than a dozen patient organisations are behind the event, which runs at the Quay Street venue from 10am to 5pm and also lives online. Organisers say the locked shelves represent more than 200 medicines that are funded in other wealthy countries but remain unfunded here, waiting on the budget of the government drug-buying agency Pharmac. The launch features four migraine treatments, with a range of other conditions represented across the shelves.
The installation’s spokesperson, Tim Edmonds, said families were being pushed into impossible positions while they waited for funding. “This is having to make decisions no New Zealander should ever have to make, remortgaging homes, setting up Givealittle pages, moving to another country,” he told RNZ. The Migraine Foundation Aotearoa New Zealand, one of the hosts, says thousands of people live with conditions for which newer treatments exist overseas but stay out of reach at home.
Pharmac sits at the centre of the argument because it decides which medicines the public system pays for and how much it will pay. It works to a fixed budget, set at about 1.76 billion dollars for the 2025 and 2026 year, and that money has to cover every medicine already funded before anything new can be added. When a drug clears the safety regulator Medsafe, it does not follow that Pharmac can afford to fund it, and applications can wait for years in the queue.
Medicines that Pharmac would pay for if it had the money go onto a register it calls the Options for Investment list. As of March this year that list held about 139 applications, and Pharmac ranks them from highest to lowest priority but keeps the order confidential so it can drive a harder bargain with suppliers. Commentators have warned the list could swell toward 400 entries within a couple of years as more high-priced treatments reach the market, which would widen the gap between what patients want and what the budget can reach.
Not everyone reads the Forbidden Pharmacy the same way. In a piece published this week, Newsroom questioned who ultimately benefits from campaigns like this one, arguing that drug companies and patient groups often line up on the same side when they press the government to fund the newest and most expensive medicines. The outlet noted that New Zealand spends around 4.9 percent of its health budget on pharmaceuticals against an OECD average of more than 13 percent, yet still sits in the top half of the OECD for overall health spending, a mix that complicates any simple claim that the country is failing its patients across the board.
The same reporting pointed to the long local timeline, with medicines often taking seven to ten years to move from Medsafe approval to Pharmac funding, compared with six to eighteen months in Australia. Supporters of the campaign say that gap is exactly the problem, and that pharmaceutical industry funding, whatever its source, does not change the fact that real patients are going without treatment. Critics counter that public pressure built around branded products can pull a limited budget toward costly new drugs and away from treatments that might help more people for the same spend.
The campaign lands in an election year and is openly aimed at whoever forms the next government, with patient groups such as Patient Voice Aotearoa having long called for the Pharmac budget to be lifted. Pharmac, for its part, has said it is trying to be more open about how it prioritises, while maintaining that a fixed budget forces genuine trade-offs that no amount of shelf space can wish away. It also argues that buying carefully and negotiating hard is how the agency stretches every dollar across the whole country.
For the families walking through Shed 10 this weekend, the argument is less about percentages and more about the packet behind the glass. Organisers hope that standing in front of a wall of locked medicines will do what a spreadsheet cannot, which is to make the people affected visible rather than reduce them to a line item. Whether that translates into a bigger budget after the election, or simply another round of the same long-running debate, is the question the installation leaves hanging over the weekend.
What do you think, should medicines access be a bigger priority for the next government, or does Pharmac’s fixed budget force the right kind of hard choices? Share your view in the comments below.
This article was written by AI, briefed to report the facts, hopefully without some of the bias people bring to the job 🙂
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