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The Government's drug buying agency, Pharmac, has reiterated it has not yet made a decision on funding two breast cancer drugs, after a press release from a support group for women with breast cancer said it had refused an application for funds.
The Breast Cancer Aotearoa Coalition yesterday said Pharmac had refused funding for Kadcyla, one of two drugs which women with advanced breast cancer hope will be funded by it.
“This is a huge blow for women with advanced HER2 positive breast cancer who took a petition to Parliament in October 2018 calling for Pharmac to fund this medicine,” Breast Cancer Aotearoa chairwoman Libby Burgess said in a statement.
A spokeswoman for Roche said Roche representatives and senior members of Pharmac met on April 12.
“At this meeting Roche was notified that currently the prioritisation of Kadcyla meant that Pharmac would be investing in other medicines. When Roche asked what those other priorities were, Pharmac would not share any further information,” the spokeswoman said.
Pharmac’s director of operations Lisa Williams said today that the agency had made no decisions on the funding of Kadcyla.
“The record of the most recent clinical expert advice Pharmac has received on Kadcyla, from our pharmacology and therapeutics advisory committee (PTAC), is due to be published in early May 2019.”
Williams confirmed that Pharmac met Roche on April 12 for a confidential discussion on a number of funding applications for medicines supplied by Roche, and other matters.
“The meeting was not about Kadcyla specifically, although Roche’s application for Kadcyla was discussed and it was informed the situation for the funding application was unchanged.
“Pharmac confirmed it had assessed Kadcyla and it had been compared with, and ranked against, other funding options Pharmac is currently considering. Roche was also informed that, as with all funding applications, the relative ranking of Kadcyla will be regularly reviewed,” Williams said.
“Pharmac regularly discusses with applicants how they might influence or change the relative ranking of their funding applications compared with others and encourages them to provide us with more evidence or better pricing offers."
Kadcyla was last ranked in 2017 and last year Pharmac’s expert cancer treatments subcommittee recommended it be funded with medium priority. The minutes of the committee were then sent to PTAC for review. It is that decision that is due early next month.
Further comment is being sought from Roche.
Burgess, who has dealt with Pharmac as far back as 2005, said today that while Pharmac had not outright declined funding, its indication that Kadcyla was not a priority meant it was unlikely to mean a positive funding decision.
BCAC yesterday lodged a petition with Parliament calling for Health Minister David Clark to provide sufficient funding to Pharmac to subsidise all the drugs listed in the European Society of Medical Oncology (ESMO) guidelines for the treatment of advanced breast cancer.
Burgess said ESMO, which published consensus guidelines for treating advanced breast cancer developed by expert oncologists, outlined 24 treatments for different sub-types and stages of advanced breast cancer that either unfunded or only partially funded in New Zealand.
“These include six drugs that are not funded at all in NZ and others that are funded for very restricted uses, preventing oncologists from using them in the most effective ways for their patients,” she said.
Pharmac said that of the $220 million it spent on cancer medicines last year, more than $100 million was spent on just five cancer medicines.
“This shows just how expensive these medicines are and why it’s so important that we’re confident they work,” Williams said.
Parliament’s health select committee is currently considering petitions calling for Pharmac to fund Kadcyla and another drug called Ibrance which could prolong the lives of women with advanced breast cancer.
Clinical trials show Ibrance, taken in conjunction with other drugs, can slow the progress of the cancer and potentially prolong the lives of patients.
In New Zealand it costs about $6000 a month, which some women are self-funding. Those who cannot afford it miss out.
The committee is also deciding whether there should be a review of the Pharmac funding model and who should carry it out.
It has been hearing submissions on the petitions and will report back to Parliament later this year.
Prime Minister Jacinda Ardern has asked Clark about options for early access to new drugs for some patients.
More than 600 Kiwi women die each year from breast cancer, the nation’s third most common form of cancer.
A day of action at Parliament is planned for May 7. That is when other petitions calling for Pharmac funding for drugs and a bigger budget for the Government’s drug-buying agency will be presented to Parliament.
The separate petitions are seeking funding for Lenalidomide to treat multiple myeloma, an incurable blood cancer; for Lynparza and Avastin to be funded for ovarian cancer; Myozyme for late onset Pompe disease, a rare and fatal metabolic disorder; and medications including Keytruda, Alectinib, Osimertinib and Crizotinib for advanced lung cancer.