A²I™ · Equity Intelligence
Landscape Gap Report
Equity evidence gaps across PTAC decisions — where equity-specific evidence was absent, which populations were affected, and what forward evidence would have supported funded access.
3
decisions with absent equity evidence
1.9%
overall equity absent rate
158
decisions with equity signal reviewed
Te Tiriti o Waitangi and PHARMAC's equity obligations
PHARMAC's statutory framework embeds Te Tiriti obligations, requiring that funding decisions consider equitable access for Māori. A decision that proceeds without equity-specific evidence may still be funded — but the absence of this data creates material risk that access criteria will disproportionately exclude high-need populations. This report surfaces where that gap exists across the PTAC corpus.
Equity gap signals by therapy area and population
| Therapy Area | Population | Decisions | Equity evidence absent | Absent rate | Common evidence gaps |
|---|---|---|---|---|---|
| Diabetes | Māori + Pasifika | 2 | 2 | 100.0% | Equity evidence gap |
| Other | Māori + Pasifika | 4 | 1 | 25.0% | Low certaintyEquity evidence gap |
| Rare Disease | General population | 8 | 0 | 0.0% | Absent evidenceLow certainty |
| Immunology | General population | 32 | 0 | 0.0% | Low certaintyAbsent evidence |
| Diabetes | General population | 4 | 0 | 0.0% | Low certaintyAbsent evidence |
| Mental Health | General population | 3 | 0 | 0.0% | Low certainty |
| Other | Elderly (65+) | 4 | 0 | 0.0% | Low certainty |
| Other | General population | 31 | 0 | 0.0% | Low certaintyAbsent evidence |
| Neurology | General population | 15 | 0 | 0.0% | Low certainty |
| Cardiovascular | General population | 8 | 0 | 0.0% | Low certainty |
| Respiratory | General population | 9 | 0 | 0.0% | Low certaintyAbsent evidence |
| Oncology | General population | 27 | 0 | 0.0% | Low certaintyIndirectness mismatchAbsent evidence |
| Other | Paediatric | 2 | 0 | 0.0% | Low certainty |
| Rare Disease | Paediatric | 9 | 0 | 0.0% | Absent evidence |
Forward evidence signals by therapy area
Diabetes
Forward Evidence Signal — Māori + Pasifika
2 of 2 decisions in Diabetes for multiple populations lacked equity-specific evidence. Common gaps: equity_evidence_gap. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Forward Evidence Signal — General population
0 of 4 decisions in Diabetes for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence, absent_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Other
Forward Evidence Signal — Māori + Pasifika
1 of 4 decisions in Other for multiple populations lacked equity-specific evidence. Common gaps: low_certainty_evidence, equity_evidence_gap. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Forward Evidence Signal — Elderly (65+)
0 of 4 decisions in Other for elderly populations lacked equity-specific evidence. Common gaps: low_certainty_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Forward Evidence Signal — General population
0 of 31 decisions in Other for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence, absent_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Forward Evidence Signal — Paediatric
0 of 2 decisions in Other for paediatric populations lacked equity-specific evidence. Common gaps: low_certainty_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Rare Disease
Forward Evidence Signal — General population
0 of 8 decisions in Rare Disease for general populations lacked equity-specific evidence. Common gaps: absent_evidence, low_certainty_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Forward Evidence Signal — Paediatric
0 of 9 decisions in Rare Disease for paediatric populations lacked equity-specific evidence. Common gaps: absent_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Immunology
Forward Evidence Signal — General population
0 of 32 decisions in Immunology for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence, absent_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Mental Health
Forward Evidence Signal — General population
0 of 3 decisions in Mental Health for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Neurology
Forward Evidence Signal — General population
0 of 15 decisions in Neurology for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Cardiovascular
Forward Evidence Signal — General population
0 of 8 decisions in Cardiovascular for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Respiratory
Forward Evidence Signal — General population
0 of 9 decisions in Respiratory for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence, absent_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Oncology
Forward Evidence Signal — General population
0 of 27 decisions in Oncology for general populations lacked equity-specific evidence. Common gaps: low_certainty_evidence, indirectness_mismatch, absent_evidence. Forward signals indicate need for real-world NZ registry data and ethnicity-stratified outcomes.
Understanding this report
This landscape is generated from PTAC meeting records spanning 2019–2025. "Equity evidence absent" means no ethnicity-stratified outcome data, Māori or Pacific patient cohort analysis, or equity access impact assessment was present in the submission at the time of the PTAC decision. It does not imply the medicine is ineffective for these populations — only that the evidence was not presented.