Melanoma drugs come at a cost

New research has ''redefined'' treatment for advanced melanoma, but at a hefty price, Dunedin oncologist Dr Chris Jackson says.

Dr Jackson contacted the Otago Daily Times about research published in the New England Journal of Medicine about immune system drugs Ipilimumab and Pembrolizumab.

They were ''fundamentally different'' from chemotherapy, he said.

The drugs, which could be used in combination, as well as on their own, shrank tumours to some extent in 60% of patients, and to a major extent in 33%.

In contrast, New Zealand's funded drug, dacarbazine, shrank tumours in 5% to 10% of patients. New Zealand and Australia have the world's highest incidence of melanoma.

Ipilimumab cost more than $150,000 for four doses, and Pembrolizumab about $12,000 a dose. Asked if the cost was realistic, Dr Jackson said it was a ''political question'', but total cost would be less than Herceptin, the breast cancer drug funded by the National led Government, which controversially circumvented Pharmac to do so.

Dr Jackson said Pharmac, which has already declined to fund one of the drugs, recognised advanced melanoma as an area of ''unmet need''.

''I believe they will be looking seriously at the treatments available for melanoma and how they can ensure cost effective therapies (or at least one) become available.''

The drugs were less toxic than existing treatments, Dr Jackson said. Pharmac director of operations Sarah Fitt, in a statement, said Pharmac was in talks with the supplier of Pembrolizumab, but had not received a funding application and had not reviewed the drug.

The drug buying agency had reviewed the other drug and declined funding on the basis of weak evidence of long term benefit, and concern over toxicity risks, she said.

Pembrolizumab was registered in the United States last year, while Ipilimumab had been on the market longer.

-eileen.goodwin@odt.co.nz

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