New Zealand is the only country with a drug-buying agency like Pharmac - but how did we get here? This episode traces its origins, and through politics and patient stories explores the tough trade-offs at the heart of our health system.

Pharmac decides which medicines New Zealanders get and which they don’t. It’s one of the most powerful institutions in our health system, negotiating hard with global drug companies to save billions. But that success comes with a trade-off: not every life-saving treatment can be funded. So how did New Zealand end up with a system like this? In this episode of Context, we trace the history of Pharmac from its creation in the 1990s to the controversial role it plays today. Along the way, we unpack how it works: the tough negotiations, the use of generics, and the cost-benefit decisions that can determine who gets access to medicine. We also explore the human side of those decisions. The cancer patients forced to go overseas for treatment. The families campaigning for drugs that aren’t funded. And the growing political pressure on a system that was designed to stay independent. As new, high-cost treatments emerge, including weight-loss drugs like Ozempic, the stakes are only getting higher. Is Pharmac a world-leading model that protects New Zealand’s health budget? Or a system that leaves some patients behind? This is the story of the trade-offs at the heart of New Zealand’s healthcare system.

Watch the video version of the episode here.

Or you can watch the full series on the RNZ website here.

Thanks to Ngā Taonga Sound & Vision.

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Go to this episode on rnz.co.nz for more details