Self-monitoring blood glucose test strip use with diabetes medicines in people with types 1 and 2 diabetes in New Zealand.

Aims: (1) To identify actual dispensings of publicly funded blood glucose test strips (SMBG) in New Zealand according to severity of disease, as proxied by the type of medicines prescribed; and (2) To compare these rates with published consensus guidelines on SMBG usage.

Method: All dispensings of diabetes medicines and blood glucose test strips (SMBG) in 2011 were identified and matched to patients, using encrypted National Health Index numbers (NHIs). Five hierarchical treatment groups were identified, as the use of: -Insulins without oral hypoglycaemic agents (OHs); -Insulins with OHs; -Sulphonylurea-containing OH regimens without insulins (with or without other diabetes medicines); -Metformin alone, with or without glitazones or acarbose; and -No diabetes medication but accessing SMBGs.

Do pharmaceutical score cards give us the answers we seek?

Few countries can afford to fund all pharmaceuticals for all of their people all of the time, and the current international economic climate brings this into clearer focus. Various agencies have tried to solve the problem in different ways, varying from funding a restricted list that applies to the whole population, to funding most medicines but with a significant part charge, or as in the United States, funding for only selected groups and leaving others to fend for themselves other than in an emergency. For countries like New Zealand and Australia who have universal health coverage but restricted (and different) lists of funded pharmaceuticals, comparisons of those lists can occur, but are problematic.

Usage and equity of access to isotretinoin in New Zealand by deprivation and ethnicity.

Aims: Oral isotretinoin, for severe acne, was until March 2009 fully funded in New Zealand only if the prescription was written by a vocationally registered dermatologist. This funding restriction was argued on the basis of complexity of management and an appreciable risk of teratogenicity if given during pregnancy or within a month of conception. However, this funding restriction had the potential to create inequitable access barriers.

Terminations of pregnancy associated with isotretinoin use in New Zealand.

Aims: Oral isotretinoin is a highly-effective treatment for severe acne. It is also highly teratogenic. Recently, funded access was widened (from vocationally registered dermatologists only) to include vocationally trained general practitioners and nurse practitioners acting within their scope of practice.