Pharmac gives nod to Humira subsidy

BY BECK ELEVEN

A drug that could remedy deformities and debilitating diseases is now subsidised by Pharmac and available across the country.

Humira (adalimumab) touted as helping painful conditions such as Crohn's disease, psoriasis and psoriatic arthritis, and ankylosing spondylitis was approved today.

Humira has been available for the past three years for people with rheumatoid arthritis, but its coverage has been extended.

Pharmac would not reveal financial details of the deal with Abbott Laboratories but said patients would spend about $20,000 a year on the drug if there was no subsidy.

Doctors' ability to treat certain diseases had been restricted without the subsidy, Christchurch gastroenterologist Dr Richard Gearry said.

"We should celebrate this because geographically defined access to health is a travesty," he said.

"There has been unequal access to this drug across different district health boards. We call it post-code prescribing."

Cantabrians have a high rate of Crohn's disease, with about 100 new cases being diagnosed each year.

"It affects young people, predominantly aged between 15 and 35, sometimes younger, often children," Gearry said.

"Aggressive forms of the disease cause abdominal pain, rectal bleeding and diarrhoea that requires lots of time off work, away from education and really takes away their quality of life.

"There's no sexy disease and this certainly isn't one, but it doesn't get the acknowledgement and appreciation its severity deserves."

He said Humira would cut the number of surgical procedures needed by patients and avoid costs, risks and complications associated with surgery.

Pharmac medical director Dr Peter Moodie said the government drug funder had been "grappling with the question of how to provide funding" for the drug without disadvantaging patients with other diseases.

Humira can be injected at home by the patient.

The funding agreement with Abbott Laboratories includes the listing of a new brand of levothyroxine for thyroid problems (Synthroid) and a price reduction and access widening for prostate cancer treatment leuprorelin (Lucrin).

FROM CRIPPLED WITH PAIN TO RUNNING A MARATHON

The simplest of tasks, such as a car journey or lunch with friends, once filled Crohn's disease sufferer Sarah McLaren with fear.

The bowel disorder, with no known cure, left the 26-year-old in chronic pain, dashing to the toilet at work and so fatigued she felt she had "lead weights strapped to her legs".

Two months after taking adalimumab (Humira), the Christchurch Hospital radiographer was pain-free "most of the time" and had run a marathon.

McLaren started feeling unwell about eight years ago with abdominal pain and a "change in bowel habits", veering from sudden diarrhoea to constipation.

After three years of chronic pain, fatigue and "embarrassing" conversations with doctors, she was diagnosed with Crohn's disease.

"It just controls your life," she said. "I ended up with stomach pain all the time, from the minute I woke up to the minute I went to sleep. I had episodes of incredible waves of pain lasting for days."

She was prescribed steroids, but symptoms returned.

A scan revealed her pain was caused by bowel obstructions that left a buildup of scar tissue. In April 2006, half a metre of her small bowel was removed.

Having a portion of bowel removed can keep some Crohn's disease sufferers symptom-free for up to 15 years, but McLaren's operation gave her just six months.

"I tried new medication but it didn't respond. I ended up developing a fistula - a pretty disgusting, horrible thing - and I worked at the hospital where I had a couple of minor procedures, so it was pretty humiliating," she said. "The fistula has healed only since I've been on Humira. There haven't been any side-effects and I'm pain-free most of the time."

Early in her diagnosis, McLaren was told by a doctor colleague not to let the disease rule her life, but at times she found the pain debilitating, depressing and exhausting.

"As a student I remember crying when I got out of bed in the mornings. It was like I had lead weights strapped to my legs, it was such an effort," she said.

"If other people with Crohn's and other auto-immune diseases can go on Humira and have the results that I have had, and had the changes that I have felt, then it just speaks for itself."

- © Fairfax NZ News