For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Independent review of ACC announced
Independent review of ACC announced

ACC Minister Matt Doocey has today announced an independent review of ACC because of concerns about declining rehabilitation rates and increasing costs.
“ACC provides critical support to New Zealanders in times of need, but I am concerned that ACC’s performance has been declining for a decade. Rehabilitation rates are down, weekly compensation costs are up and average costs per claim are up,” Mr Doocey says.
“This imposes significant costs on households.
“Today I am announcing that the earners and business levy is having to be increased by up to 5 per cent a year for three years to meet the rising costs of the scheme.
“For somebody on the median full-time wage of about $70,000 a year this equates to an additional $42 for the 25/26 financial year, or 80c a week, and an increase of $140 in three years’ time from this year’s levy rate.
“The levies paid by motor vehicle owners are also being increased by 5 per cent plus an inflation adjustment per year for three years.
“This review will have a particular focus on claims management. It will look at whether ACC has the right interventions and settings in place to support accident claimants to return to independence as quickly as possible.
“Alongside the review, I am working with the ACC Board and the Ministry of Business Innovation and Employment to strengthen performance monitoring and achieve more targeted and cost-effective social rehabilitation services.
“My priority is getting Kiwis rehabilitated and back to work and independence quickly. To achieve this, we must ensure ACC is set up to reduce long-term dependency and improve health outcomes, building on its 50 years of delivering injury prevention and no-fault personal injury coverage for New Zealanders.
“I know that many Kiwis are doing it tough. The staging of the increase in ACC levies reflects this.”
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