10,000+ Māori going untreated for gout

By Will Trafford
Video: Scientific Animations / Kidney Fund

The government’s drug-buying arm Pharmac is conceding more than 10,400 Māori suffering from gout have been underserved by the medical establishment and should be on preventative treatment for the life-long arthritis.

The organisation has released the first of a series of reports investigating inequities in medicine access. Pharmac says its research shows Māori are 6.9 times more likely to be hospitalised with gout than non-Māori and non-Pacific peoples but are less likely to receive preventive medicine before or after hospital admission.

"Our research suggests more Māori need to be started on preventive gout medicine at a younger age to achieve better health outcomes," the organisation’s chief medical officer Dr David Hughes says.

Hughes says work within the broader healthcare system is required to address the inequality of outcomes within the system.

"Making this happen will take all parts of the medicines system to understand the extent of the access equity issues and what they can do to address it."

Gout affects about 6 percent of adults aged over 20. Biological factors such as kidney disease and genetic variants mean Māori are more susceptible to severe or early-onset gout, with men affected at roughly three times the rate of women but Royal New Zealand College of General Practitioners medical directors Dr Bryan Betty says while it’s sometimes debilitating, the symptoms and complications of gout are preventable, especially if people take daily medicines such as allopurinol and probenecid.

"This report raises awareness and highlights the equity issues over clinical management of gout in New Zealand, which differentially affects Māori and Pasifika."

"It is very important to raise awareness about gout and the need to have more equitable access to medication," he says.

Pharmac says advancing Māori health equity with an eye to Te Tiriti of Waitangi principles is a top priority for the organisation. Last month the agency appointed its first Wahine Māori as head of the group which recommends which drugs to fund but Pharmac’s kaitohutohu, Trevor Simpson, says the entire medical establishment beyond Pharmac needs to respond to their latest research.

"The insights are concerning but not surprising. There are systemic and societal influences that we all need to address to achieve equitable outcomes. While research like this supports our goal for Māori to achieve their best health and wellbeing, we know we can’t achieve this alone," he said.

Simpson says the organisation is committed to using the research data in the series of additional reports that will target cardiovascular disease, diabetes, asthma, and chronic obstructive pulmonary disease to advance Māori health equity.

"We are using the data and insights and working with our partners across the health and disability sector to see real changes from policy to primary healthcare. We’re also examining our own processes for improving access to funded medicines," he said.

The Pharmac report can be viewed here.