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Comparable Countries

What is a 'comparable country'?

“Comparable Countries” refers to countries with comparable health systems to New Zealand’s such as the United Kingdom, Australia and Canada1. However, these countries (and others) have broader and more timely access to modern medicines than New Zealand currently because of more responsive processes, stronger funding models and higher investment levels2. Many of these countries have well established processes to formally embed patient involvement into the assessment processes for funding decisions, in New Zealand, efforts to reform assessment processes to better incorporate patients perspectives are only just beginning. 

How does our access actually compare to other countries?

Across the OECD, countries publicly fund a markedly greater share of new medicines than New Zealand, which sits well below the OECD average, and our closest peers3

When this funding picture is set alongside the country's GDP per capita, a stark pattern emerges - New Zealand is a relatively high-income country (we’re above the OECD average), yet many nations with lower incomes provide better access to new medicines3,4

How does our medicines funding system compare to other countries?

The limitations in our medicines access can be understood more clearly when New Zealand’s medicines funding system is set alongside countries with similar public health systems. The table below compares key features of the medicines procurement and funding systems in New Zealand, Australia, the United Kingdom and Canada, including budget settings, access performance, time to public funding, patient involvement in funding decision making, and the role of cost‑effectiveness5,6.

Our input mix doesn’t prioritise medicines7


New Zealand is also an outlier in how our health budget is broken up, with higher allocation to services and less to medicines. 

New Zealand invests 4.9% of health expenditure into medicines, in comparison, the OECD average is 13.3%. 

Glossary

CADTH – Canadian Agency for Drugs and Technologies in Health
An independent organisation that reviews evidence on medicines and health technologies to support informed decisions made by Canada’s publicly funded health care systems. 

Cost-effectiveness / costeffectiveness analysis
An economic analysis used to compare how much health benefit different treatments provide for the money spent to help decide which ones should be publicly funded.

Costutility analysis
A type of cost-effectiveness analysis that uses QALYs to compare the value for money of different treatments.

GDP – Gross Domestic Product
The total monetary value of all the final goods and services from a country over a period, this is used to measure a country’s economic growth

Health expenditure
The total amount a country’s government spends on public health, including hospital care, visits to health professionals, medicines, and other services and support.

Market Access Index (Score)
A single number that sums up how well a country provides public access to new medicines, compared with the best‑performing country (in this case Germany), so results can be easily compared.

Modern medicines / new medicines
Recently developed prescription medicines, often using newer science or technology, that have been approved for use and are important additions to treatment options.

NICE – National Institute for Health and Care Excellence (United Kingdom)
An independent body that advises the NHS on which medicines and treatments should be funded, based on their benefits, risks and value for money.

OECD – Organisation for Economic Co-operation and Development
An international intergovernmental organisation mainly consisting of high‑income countries that works together to promote economic growth, trade, and improved social well-being through shared data, analysis, and policy standards.

PBAC – Pharmaceutical Benefits Advisory Committee
An Australian independent advisory committee which makes recommendations to the Minister of Health and Aged Care regarding which medicines should be listed on the Pharmaceutical Benefits Scheme.

PBS – Pharmaceutical Benefits Scheme (Australia)
Australia’s national programme that provides subsidised access to prescription medicines

pCPA – pan‑Canadian Pharmaceutical Alliance
A group that negotiates medicine prices on behalf of Canada’s provincial and territorial governments so they can get better value from public funding.

Pharmac (New Zealand)
The government agency that decides which medicines and related products are funded for use in New Zealand’s public health system.

Publicly funded medicines
Medicines that are paid for, or heavily subsidised, by the public health system so people can get them at low cost or no cost, rather than paying the full price themselves.

QALY – quality‑adjusted life year
A way of measuring the benefit of a treatment that combines how much longer people live and how good their quality of life is during that time.

TGA – Therapeutic Goods Administration
The Australian regulatory authority for medicines and medical devices.

 

Sources

  1. Medical Council of New Zealand. (2019). Comparable health system criteria. Available from: https://www.mcnz.org.nz/registration/getting-registered/registration-policy/comparable-health-system-criteria
  2.  IQVIA. (2020). International Comparisons of Modern Medicines 2011-2018 (ICoMM 2). Available from: https://www.medicinesnz.co.nz/fileadmin/user_upload/IQVIA_ICOMM_2020_report_May2020_Final.pdf
  3. PhRMA. (2023). Global Access to New Medicine Report. Available from: https://www.medicinesnz.co.nz/fileadmin/assets/2023-04-18_Global_Publicly-funded_Access_to_New_Modern_Medicines_Report_FINAL.pdf
  4. OECD. (2025). Pharmaceutical expenditure. In Health at a Glance 2025. Available from: https://www.oecd.org/en/data/indicators/pharmaceutical-spending.html
  5. Bristol Myers Squibb Australia/New Zealand. (2026). Access to Innovative Pharmaceutical Medicines in New Zealand. Available from: https://www.bms.com/assets/bms/newzealand/documents/Access%20to%20Innovative%20Pharmaceutical%20Medicines%20in%20New%20Zealand%202026.pdf
  6. Medicines Australia. (2019). Comparison of Access and Reimbursement Environments (COMPARE) Report (5th Edition). Available From: https://www.medicinesaustralia.com.au/wp-content/uploads/sites/65/2020/11/MA-Compare-Edition-3-October-2017.pdf
  7. NZIER. (2025). Health Priorities? A comparison of New Zealand’s public health and disability expenditure against selected OECD countries. Available from: https://www.medicinesnz.co.nz/fileadmin/user_upload/Publications/2025/Health_Priorities_NZIER_final_report_October_2025.pdf