Breast Cancer Aotearoa Coalition (BCAC)
www.breastcancer.org.nz
Media Release, Auckland 20 March 2007
For Immediate Release

It's all about the money with Pharmac

'Pharmac's proposal to fund an unproven 9 week course of Herceptin for women with early stage HER2 positive breast cancer is driven by cost, not sound, evidence based medicine,' says Breast Cancer Aotearoa Coalition (BCAC) Chair, Libby Burgess.

Pharmac has based its funding decision on a small Finnish trial, FinHer, in which only 54 women received the 9 week treatment Pharmac now proposes to fund. The trial was too small to show whether this treatment had overall survival benefits.

'Pharmac have ignored the results of several large international trials involving over 12,000 women that demonstrate strong survival benefits of 12 months treatment,' said Burgess. '23 OECD countries have funded the proven 12 month Herceptin treatment while New Zealand women look set to be offered an unproven 9 weeks.'

Opting for the 9 week treatment will cost Pharmac $6 million/year compared to an estimated $20 - 25 million for 12 months. BCAC believes the $6 million/year of taxpayers' money will be ill spent on a regime that could cost the lives of New Zealand's women.

Pharmac's expert cancer committee (CaTSoP) recommended funding the 12 month Herceptin regime last year but the clinical advisory committee, PTAC, with no specialist oncologists as members, decreed it would only fund the 9 week option. 'Pharmac's expert cancer committee was forced to consider 9 weeks or nothing at all,' said Burgess.

'If Pharmac already believes 9 weeks of Herceptin works,' said Burgess, 'why are they giving an additional $3.2 million of taxpayers' money to a researcher in Finland to perform a study to test that? Pharmac's role is to invest money into medicines that New Zealanders are crying out for, not offshore experiments.'

The trial may not go ahead if overseas researchers do not support it. If it does, data would not be available for 4-6 years, during which time only the 9 week treatment will be government funded. New Zealanders will be unable to access the proven treatment of 12 months unless they are able to pay for it or they happen to be randomised in the trial to receive it. If 12 months is then proven to be more effective than 9 weeks, NZ women off trial will have been subjected to a substandard treatment instead of receiving the internationally accepted and adopted standard of care. If the trial does not happen it will never be known if 9 weeks is beneficial.

Since Pharmac's formation in 1993, the pharmaceutical spend under its management has decreased from 11% of the health budget (an OECD average) to less than 6% in 2006. The average New Zealand spend per capita is less than half that of Australia.

Ms Burgess said the Herceptin debacle offers a classic case of bureaucrats overriding medical experts to prescribe treatments for patients. 'Pharmac's refusal to invest in the proven, evidence based, 'gold standard' Herceptin treatment regimen of 12 months sets a dangerous precedent for the future funding of other high priced pharmaceutical treatments. This issue will arise over and over as new products come up for funding consideration and if a bad process is allowed to proceed now, the people of New Zealand will suffer.'

ENDS

About the Breast Cancer Aotearoa Coalition
www.breastcancer.org.nz

The Breast Cancer Aotearoa Coalition (BCAC) is an Incorporated Society with charitable status, presenting a unified voice to call for change, improvement and innovation on behalf of all New Zealand women experiencing breast cancer.

BCAC was formed in November, 2004 when twelve New Zealand breast cancer organisations came together at a forum to create one group. BCAC now has sixteen member organisations and is currently working on five major initiatives:
1. to ensure consistent, high quality detection and treatment of breast cancer throughout New Zealand by promoting the development and implementation of evidence-based best practice guidelines;
2. to support the prompt and effective implementation of the extended age breast-screening programme (45 to 69);
3. to inform and advocate for improved access to breast cancer treatment drugs;
4. to research and promote the provision of professional psychosocial services for breast cancer patients and their whanau, family, friends and supporters;
5. to identify and promote breast cancer issues for Māori and Pacific Island women

Ends

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