Pharmac's board chair says the drug buying agency has a management issue with listening to patient voices.
A review of consumer engagement with the Government agency finds it's seen as 'defensive'.
It also says Pharmac's slow to respond and lacks respect for patient advocates.
Chair Paula Bennett says the organisation had become insular and inward-looking - more often than not.
"And instead of proactively having what are really awkward and uncomfortable and difficult conversations with people when we're saying - I'm sorry, I can't fund your medicine. But at least doing that in an open and transparent way is what we expect."
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