"Tough but fair"? The active management of the New Zealand drug benefits scheme by an independent Crown agency

For just over a decade, New Zealand has relied on an independent Crown agency to manage the public drug benefits scheme. It was established after a period of industry litigation and unsustainable budgetary increases. The agency has successfully contained prices, saving the equivalent to its originally allocated budget every year, despite a 50% increase in volumes. It shares features with similar agencies elsewhere in the world, particularly in its independence and its operational methodology. Opposition from the industry and ambivalence in the medical community remain matters of concern. The fate of such agencies is inextricably linked to wider regulatory and policy settings in the health sector.