Pharmac has released the Pacific peoples health – Gout data insights report showing that while the prevalence of gout in Pacific Peoples continues to climb, access to preventive gout medicine remains inequitable.
The latest insights show that Pacific Peoples aged 20 years and older are about three times more likely to live with gout when compared to non-Māori, non-Pacific Peoples.
“We’ve found that Pacific Peoples start being dispensed preventive gout medicine approximately 13 years earlier than non-Māori, non-Pacific peoples,” says Pharmac’s Chief Medical Officer Dr Hughes. “And Pacific Peoples are approximately three times as likely to be dispensed medicine for gout compared to non-Māori, non-Pacific peoples.
“But this is still not enough. About 8,700 more Pacific Peoples need preventive gout medicine each year to achieve equity of access to medicines.”
Gout is a form of arthritis that sets in when high levels of uric acid build up in the blood and solidify as painful crystals in joints. It is a life-long condition that can reduce someone’s life expectancy and quality of life.
“For Pacific Peoples, biological factors – such as kidney disease, genetic variants, and some medicines – contribute to a higher prevalence of gout when compared to non-Māori, non-Pacific peoples,” explains Dr Hughes. “With access to preventive medicine, gout symptoms and risk of complications can be effectively managed.”
Dr Apisalome ‘Api’ Talemaitoga, GP and Chair of the Pacific GP Network, understands the impact of gout arthritis for Pacific Peoples from a first-hand perspective.
“There are many barriers that make it harder for Pacific peoples to access medicines for gout,” says Dr Talemaitoga.
Arthritis New Zealand Chief Executive Phillip Kearney hopes the findings challenge stigmas around what causes gout arthritis.
“From the perspective of consumers, it is vital to see community and health groups working together to counter the stigma and myths that surround gout arthritis,” says Mr Kearney.
“A successful example of this collaboration can be seen in our Pacific community gout arthritis education project in Porirua. This project brings together clinicians, pharmacists and community leaders to work with Pacific communities and their whanau to help develop their knowledge and understanding of gout arthritis and how it can be successfully managed. The key to the success of this programme is collaboration and involvement of Pacific Peoples at every stage, so it is a true community initiative.”
Mr Kearney, Dr Talemaitoga, and Dr Hughes agree that Pacific Peoples’ realities, worldviews, and aspirations of health and wellbeing must be central when driving interventions and developing solutions.
“This is the second report using a new and important monitoring framework to measure trends in medicine access inequities. It will be useful across the health and disability sector and Pacific communities, including health practitioners, health workers, policymakers, researchers, and groups who have an interest in addressing the health needs of Pacific peoples,” says Dr Hughes.
“We hope it prompts discussion and action around tackling health inequities for Pacific Peoples, strengthening Pacific health excellence, and ensuring culturally safe and competent practice and decision making.”
Dr Talemaitoga says, “While the insights add new knowledge to our understanding of medicines access in New Zealand, we recognise that understanding and eliminating inequities in access to medicines will require new approaches and initiatives.”
As well as examining its processes to improve access to funded medicines for Pacific Peoples, Pharmac is working with organisations across the health and disability sector to support health professionals. This includes a partnership with Matui to provide equity-focused education and prescribing tools for clinicians delivering primary care through He Ako Hiringa.
Pacific peoples health – Gout data insights is the second report into medicine access inequities for gout as part of Pharmac’s monitoring and outcomes framework. It follows the release of Gout insights – Impact on Māori in December 2021.