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A Dunedin doctor who has chosen to pay $50,000 for her own 12-month Herceptin treatment believes more money could be found in Pharmac's budget for the breast cancer drug if it took a closer look at what it is spending on medicines for gut problems such as indigestion.
Dr Sue Walthert (53) points out that Pharmac's review of 2007 expenditure shows it spent $16.6 million on chemo-therapeutic drugs including Herceptin, but in the same year they sent $75.5m on drugs to treat stomach upsets, like indigestion, heartburn and ulcers. This expenditure had risen from $44m in 2002 and made up 8% of its total budget.
She questions expenditure on complaints that were mainly the result of overeating, under-exercising, smoking and drinking alcohol, which could be prevented with a little self-discipline.
Pharmac was running a programme promoting best practice of medicines for gastric reflux and heartburn, but by a few strokes of the keyboard it could reintroduce restricted prescribing of drugs such as Omeprazole (used for stomach complaints) and save the $25 million it is estimated it would cost to fund all women who might want the 12-month Herceptin course.
Pharmac needed to start engaging with the public so they could start becoming part of the decision-making about drugs.
‘‘Herceptin is not the only drug going to present a challenge. It's only the beginning.''
Her breast cancer was diagnosed after her regular mammogram last April. The cancer in her right breast was at an early stage, with no lymph nodes affected.
Dr Walthert said she was really pleased she had not put off having the mammogram, even delaying it a few months she ‘‘might not have had such a good result''.
After a mastectomy and chemotherapy, Dr Walthert was faced with the decision about Herceptin treatment. She qualified for the nineweek course, but decided to continue treatment over 12 months after she asked her oncologist ‘‘what he would advise his wife if this happened to her''.
His response was that the strength of evidence available favoured the one-year course, something her own research has supported.
She is concerned that Pharmac's support for the nine-week course is based on one trial, involving only 54 women, compared with four trials treating women for a year with an average of 2966 women in each trial.
It was like a political party basing its election campaign on one opinion poll of 54 compared with several polls of 3000 people, she said.
Finding the money meant cutbacks, including she and her husband Eddie postponing a visit to their daughter in Switzerland, but having cancer ‘‘tends to change your attitude to money anyway''.