Pharmac "lack accountability, lack transparency, are slow", in delivering pharmaceutical drugs to New Zealanders who need them according to the Cancer Society.
This morning on TVNZ1's Breakfast, Cancer Society's medical director Dr Chris Jackson said it was "beyond any shadow of a doubt" the access to cancer drugs and treatment was better in Australia, Canada and the UK than in New Zealand.
"The UK internationally is regarded as a low-tide mark for access to drugs and we're even behind them," Dr Jackson said.
"We're behind in access to melanoma drugs, breast cancer drugs, bowel cancer drugs and prostate cancer drugs."
He said New Zealand does not invest enough in cancer medicines and "almost have this nihilism towards cancer therapy, that it's OK that we don't give people with cancer access to medicines, which is just not the case".
Dr Jackson said it was "heart-breaking" to talk to people in his clinic about drugs they could have if they had the funds.
He said a difference between Australia and New Zealand was the capped budget in New Zealand.
"One of the disappointing things from Pharmac is they aren't really bidding very strongly for greater funds to spend."
He said Pharmac "lack accountability, lack transparency, are slow to reach their decisions and they don't engage with the specialists and the communities other than the ones they employ on their committees".
However, on TVNZ1's Q+A last night, Pharmac CEO Sarah Fitt said "just because you fund more medicines, doesn’t necessarily mean that you get better outcomes".
"We have to make difficult decisions around which medicines we spend money on. Because for every medicine we fund, there’s a risk that there's another medicine that we don’t fund."
Ms Fitt said Pharmac have significantly increased its spend on cancer medicines but they "have to be absolutely sure that the evidence stacks up".
Ms Fitt signalled the drug buying agency could look at a specialised fund that deals with new cancer drugs and new emerging technologies, similar to a model used in the UK.
"The first version a couple years ago, they found that if they'd spent that money elsewhere in the National Health Service, they would have got five times better health outcomes for their population.
"They've since reviewed that cancer drug fund, and there’s a second version in place now, which we’re watching with interest."
Ms Fitt says Pharmac has committed to making decisions faster and will move to declining some applications to give people more certainty. She said the agency is open to an independent review.
"We believe that we are putting steps in place to improve our decision-making process, to make it faster, clearer and simple. But if there was to be a review, we would happily participate in that."