The cost of cancer medicines
But another reason is the extraordinary cost of new cancer medicines, particularly while they are under patent. Once a medicine is approved by Medsafe (New Zealand’s drug-buying agency), Pharmac (New Zealand’s drug-buying agency), starts a process to assess whether it will fund that medicine or not. This can throw up three key issues for those people who could benefit from these medicines. The first is the time it takes Pharmac to approve a new therapy; for instance, lung cancer patients have been waiting more than a year to find out whether the agency will approve the use of Keytruda to treat their condition.4
The second issue is that sometimes Pharmac decides not to fund a medicine. This could be for a range of reasons, including the potentially high cost of a medicine relative to the number of people who would benefit. Such criteria are legitimate, however many point out that there are medicines that are publically funded by Australia’s government that are not funded by Pharmac in New Zealand. The cost gap between what Pharmac funds and what the latest cancer treatments can offer was laid bare by the Cancer Society in 2016, when it stated that: “Immunotherapy treatment costs about $10,000 a month… doctors are having to tell their patients and their families if they don't have the money, they cannot get treated”. 5 The Cancer
Society put this down to many factors, but made it clear in its position statement that New Zealanders were not getting the access to the medicines that they should expect.
One cancer medicine that’s been approved by Medsafe but which is not funded by Pharmac is Avastin. It’s not a cure, but it has been shown to slow down the growth of tumours, potentially helping patients live longer, and so enjoy more time with their family and friends. Avastin is effective against advanced cancers of the breast, bowel, cervix and ovaries, amongst others. The cost of a course of Avastin varies from patient to patient, but the maker of Avastin estimates a price of between $25,200 and $50,400 plus GST for a 70 kilogram patient.
“Immunotherapy treatment costs about $10,000 a month… doctors are having to tell their patients and their families if they don't have the money, they cannot get treated”
The third issue is that while Pharmac does fund many cancer medicines, and spends millions doing so, there are often eligibility criteria. For instance, some medicines are only funded if a cancer has metastasized – leaving patients in the unenviable position of having to choose between selling their house to pay bills, or waiting for their condition to become serious enough for Pharmac’s funding to kick in.