Govt goes ahead with Herceptin promise
Prime Minister John Key does not think a decision to circumvent drug funding agency Pharmac will set a dangerous precedent.
The Government is extending from nine weeks to a year funding for breast cancer drug Herceptin by paying for it through the Health Ministry, rather than drug funding agency Pharmac.
National pledged during the election campaign to extend funding for the drug for Her-2 positive breast cancer and Mr Key today confirmed that and released details.
Pharmac had refused to fund more than a nine-week course, saying scientific and other information had failed to convince it that the longer course offered any additional benefits over the nine-week treatment it did fund.
Former Health Minister David Cunliffe said he could not overrule Pharmac.
The new Government has got around that by funding the extension through the ministry.
Mr Key said he had made a promise to women with breast cancer and he was not going to abandon them.
"We asked New Zealanders to trust our word. I think it would be appalling if we became the government and then walked away from those hundreds of women who we promised we would pay for a full year course of Herceptin for."
Asked if it set a precedent for getting around Pharmac, Mr Key said drug companies always lobbied government.
Mr Key thought Pharmac made its decision on Herceptin "largely" on funding issues.
"Pharmac was very heavily constrained, its budget hadn't been increased in any dramatic way, this was a reasonably sizable expenditure item for them and they rejected a 12-month funding of Herceptin - in my view partly driven off a lack of financial resources."
Mr Key said the Government got "a pretty good deal" for the longer course.
In a statement Pharmac said it helped the ministry in its negotiations with supplier Roche and by providing information.
"Pharmac fully respects the democratic process that has led to the Government's decision to fund 12-month treatment with Herceptin," the statement said.
The nine-week course would continue to be funded through Pharmac.
Mr Key said the 12-month course funding was backdated to November 19 when the Government was sworn in.
Women who paid for Herceptin treatment privately between then and now, about 30 women, could seek reimbursement from the ministry.
"The Government expects that over time, up to 300 women a year will benefit from the year-long course."
Mr Key said women who had already completed the nine-week course could see their specialist about getting a 12-month course.
Health Minister Tony Ryall said the extension would be funded from the Government's planned $180 million new money for pharmaceuticals over the next three years.
Women already on the nine-week course can continue for the year period. Women who choose to continue receiving treatment privately will only be funded for the cost of the drug and not the delivery.
Patients who recently completed a publicly funded nine-week treatment or recently discontinued a private 12-month course of Herceptin treatment may now be able to receive the balance of a 12-month course of treatment publicly depending on their specialist's clinical judgment.
Mr Ryall said as a result of the decision more patients would attend outpatient clinics and extra staffing would be needed in the long-term.
The Government would provide additional funding up to $3.6 million per annum to support the additional costs of administering the drug. The cost of the drug was not being released for commercial sensitivity reasons.
Mr Ryall said the benefits of using Herceptin to treat early breast cancer were well-known and recognised internationally.
The benefits of Herceptin have been reported in a number of international randomised trials and 34 other countries offer 12 months Herceptin as the standard of care.
Clinical trials found Herceptin had a small risk of significant side effects, such as heart failure, and that this risk may be increased with longer courses. Specialists and women would take that into consideration.
Labour's health spokeswoman Ruth Dyson said the Government had set a dangerous precedent by overruling medical experts.
"There are many people with significant illnesses who are not able to get access to government-funded medication. I really don't know how this will make them feel. They will ask why them and not me," Ms Dyson said.
The next step for those groups would be for them to lobby politicians and also for drug companies to push their products.