A review of Pharmac has found the drug-buying agency is getting some of the best prices possible but has contributed to health inequality for Māori and Pacific peoples.

And people with rare disorders have faced disproportionately negative health outcomes due to systemic failings, the review found.

The agency had a difficult job but needed to improve transparency and have more empathy for consumers, the review panel added.

The review also found the Ministry of Health should overhaul guidance for the public sector medicines strategy.

"The existing strategy is widely considered to be out of date because of changes in the medicines and wider health sectors in the past 15 years," the panel said.

"It does not, for example, account for the emergence of treatments for some cancers or costly biological medicines that are individually targeted to patients with rare disorders."

An analysis of Pharmac's decision-making process found equity considerations were not given enough weight in investment decisions.

Investment in cancer medicines had tended to favour urban residents and ethnicities other than Māori and Pacific peoples, the panel added.

The review into Pharmac was announced in March last year. An interim report was then released nine months later.

Health Minister Andrew Little then received the independent review's final report.

An embargoed copy of the 136-page independent report was released shortly before a scheduled press conference with Little this morning.

The review found all countries were facing pressures on pharmaceutical budgets.

It said regardless of how much money was spent, increasingly tough decisions had to be made about what drugs taxpayers should fund.

"Given this environment, it is difficult to conceive of a situation where anything other than a fixed-budget, centralised specialist function would achieve better pharmaceutical assessment and cost management results," the report found.

Former Consumer NZ chief executive Sue Chetwin chaired the review panel.

The panel said for now, it made sense for Pharmac to continue as a Crown entity but in future it could be worth reassessing the agency's role in the health system.

The final report also said Pharmac was having to contend with a proliferation of new medicines and pharmaceutical companies.

Today, the Health Minister said the drug-buying system was set up nearly three decades ago and with Health NZ reforms staring in July, it made sense to reassess Pharmac.

"The panel found Pharmac's model has delivered significant benefits, but to achieve its purpose these benefits need to be shared more equitably across our communities, especially for Māori and Pacific peoples," Little said.

Debate over unfunded drugs re-emerged in April this year after the Cancer Control Agency said many people were missing out on potentially life-saving treatments.

The agency identified 20 different gaps across nine different cancer types where medicines were publicly funded in Australia, but not in New Zealand.

Other groups identified dozens more funding gaps in cancer drug funding.

And dozens of people visited Wellington last month to see what support in Budget 2022 the Government would offer people suffering from rare illnesses.