In an industry paradigm shift, AIA now allows families to access its high-value immunotherapy cover through AIA’s Cancer Treatment Benefit without changing insurance provider. This will increase consumer choice and provide thousands of Kiwis access to innovative, expensive and potentially life-saving cancer treatments.
Families have previously been denied access to specialist insurance products not offered by existing insurers, such as Southern Cross, because switching health insurance providers in New Zealand can be challenging as pre-existing health conditions may not be covered by a new insurer.
“The insurance market in New Zealand has a history of taking an exclusive approach to policies,” says AIA New Zealand Acting Chief Executive Officer Graeme Edwards. “AIA’s Cancer Treatment Benefit, however, is an example of how an insurance product from one provider can enhance a consumer’s existing policy with another provider.”
It also addresses an urgent need facing families relying on the public health system: “We have one of the best public health systems in the world but people do worry about getting the right diagnosis and treatment for cancer in a timely manner given the lengthy waiting times for treatment,” he says.
“Identifying cancer early and having access to the latest generation of immunotherapy medicines could vastly improve someone’s odds of surviving cancer. The Cancer Treatment Benefit ensures immediate access to specialists, diagnostic tools and a full range of medicines without being reliant on public funding of expensive cancer medicines,” says Edwards.
The Cancer Treatment Benefit – an add on to AIA’s REAL Trauma cover, minimum $100,000 cover – provides non-surgical cover up to $500,000 per year for specialist consultations and tests for the diagnosis of cancer. Should cancer be diagnosed, it provides access to Pharmac and non-Pharmac treatments and the latest Medsafe-approved cancer immunotherapy medicines.
“In a global environment of rapidly escalating health costs, it is imperative that insurers address the affordability of new generation anti-cancer treatments,” Edwards says.
“New Zealanders ought to have access to cancer immunotherapy medicines if they want and need them, and AIA’s bolt-on Cancer Treatment Benefit gives them this choice,” he says. “It offers cover for cancer care from diagnosis and treatment, through to recovery and potential cure.”
Medical professionals are hailing cancer immunotherapy drugs as a new pillar in oncology treatment but are decrying the cost of the drugs as precluding all patients but the very wealthy.
Cancer immunotherapy drugs are being trialled globally, and the efficacy of the treatment is such that some drugs are already available – but at a high cost to patients.
Melanoma and lung cancer drug Opdiva costs $235,000 for a year of treatment; Yervoy (previously treated or newly diagnosed advanced melanoma) is $204,000 for a 12-week course; and advanced prostate cancer drug Provenge, a series of three immunotherapy vaccines, requires an outlay of $146,000 per patient.
While Pharmac was given a funding boost from Government and DHB coffers last year, Edwards says the private sector needs to support this with new funding solutions so that more lives can potentially be saved.
“Kiwis already have access to a lesser range of innovative medicines and treatments compared to Australians, and funding constraints means national drug-buying agency Pharmac will struggle to afford the new range of anti-cancer drugs,” he says. “The insurance industry has an important role to play in providing access to non-Pharmac drugs, such as cancer immunotherapy medicines.”
Government spending on healthcare as a percentage of GDP more than doubled between 1950 and 2011 and, according to Treasury forecasts, on the present trajectory will account for nearly one third of all government spending by 2050. A report published in 2015 by the New Zealand Institute of Economic Research concludes that, based on international evidence, private health insurance (PHI) has an important part to play. It estimates that PHI currently contributes $1 billion annually to total health expenditure in New Zealand and increasing PHI to the level of France, for example – which leads the OECD in terms of PHI penetration and coverage – would triple this funding and could foster cost savings and ease pressure on the public sector.
“We are all concerned about the escalating costs of new generation drugs, particularly for oncology,” says Edwards. “With a raft of new drugs in trials, there is great uncertainty around the future cost of next-generation medicines.”
AIA is a leader in product innovation in the insurance market. In October 2015 it was the first insurer to lift its REAL Health cover to up to $500,000 (per policy per year) for Surgical, Medical and Cancer Treatment benefits.
“We’re serious about investing in New Zealanders’ health and AIA’s Cancer Treatment Benefit is a natural progression in our product innovation,” Edwards says.