Chatswood serves the life and health insurance sector in New Zealand with market intelligence, data, and bespoke consulting services. Some of these are provided in conjunction with Quality Product Research Limited - a subsidiary that brings you Quotemonster.

We believe that good decisions are more likely to occur when we have good information about the market environment in which we operate. Intuitive leaps and creative decisions are always required, of course, but the more they are based on a firm foundation of observation, the better they tend to be.

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Jon-Paul Hale critiques insurers' use of “MedSafe indicated” wording in policies

Jon-Paul Hale critiques insurers' use of 'MedSafe indicated' wording in policies, saying if clinicians and customers were more aware of what the wording meant they may change their treatment plans.

Jon-Paul Hale critiques insurers' use of 'MedSafe indicated' wording in policies, saying if clinicians and customers were more aware of what the wording meant they may change their treatment plans to ensure that coverage extends to the use of the medicine.

In policy wordings, “MedSafe indicated” can significantly limit access to treatment; where MedSafe guidelines include "indicated first-line treatment", this means the medication is only authorised for use as the first treatment. Hale suggests that clients consider any mediations with ‘first-line’ indications may wish to be treated with these medications first, as insurers are unlikely to approve them for later use.

What may surprise you is that many, many, medicines are prescribed that are outside Medsafe indications. Some are prescribed even though the medicine is unapproved for any purpose in New Zealand. Several insurers will not cover medicines that are unapproved. Obtaining a Medsafe approval for the use of a medicine can be time consuming and expensive. We are a small market and some disorders are rare. That means that while it may be economically viable to gain approvals in the United States and Europe, sometimes the New Zealand market may be too small for these companies to consider seeking approval economically viable, especially when some medical professionals will still prescribe an unapproved medicine.

At Quality Product Research Limited we are committed to ensuring that research scores are descriptive of these differences, which are increasingly important. There is a review of the non-PHARMAC coverage item in our health / medical insurance research which is being consulted on right now. If you would like to participate in the review please contact us. Results of the review will be announced at our forthcoming national roadshow which runs from 23 July to 29 August. Register for the roadshow, at a venue near you, here.

References:

Medsafe – about and role: https://www.medsafe.govt.nz/other/about.asp

Medsafe – use of Unapproved Medicines and Unapproved Use of Medicines: https://medsafe.govt.nz/profs/riss/unapp.asp#need

 

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Star Wayfarer Award: Recognising individuals who have made significant contributions to improving health and wellbeing within their workplaces, regardless of their position.

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Wayfinder Large Business of the Year: Recognising large businesses with 500 or more employees.

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