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DHB's response to PHARMAC’s decision

21 District Health Boards

Thursday 7 August

District Health Boards’ response to PHARMAC’s decision to continue 9 week Herceptin treatment

Comments to be attributed to Murray Georgel, Lead CEO PHARMAC Relationship (and CEO, MidCentral District Health Board)

Editors please note there are two pages to this release.


District Health Boards (DHBs) acknowledge the distress that breast cancer sufferers and their families face. Our clinicians and staff do the very best they can to treat women with this illness and in doing so use the information, advice and resources available to them. One such resource is PHARMAC.

In the absence of advice that provides DHBs with alternative compelling information, we accept PHARMAC’s position that there is no current basis to support funding for 12 month treatments with Herceptin.

While DHBs continue to hold funding for cancer medicines, DHBs rely on advice from PHARMAC about which cancer medicines should be funded. This national focus ensures that funded cancer medicines are available nationally, avoiding the risk of some DHBs funding some things, and others not. There would also be significant additional costs if each and every DHB had to carry out a funding assessment. PHARMAC makes a recommendation to DHBs when funding is requested, and this advice is – given PHARMAC’s speciality in assessing medicines – considered very carefully. In this instance, a funding recommendation was not put to DHBs for consideration.

We believe that this was not a decision taken lightly by PHARMAC. The key reason that PHARMAC noted for not funding 12 months – no certainty of better health outcomes – is one DHBs can understand. In that context, and given the ability of DHBs to improve health through other interventions, it would have been concerning if PHARMAC had come to DHBs and asked that the 12 month treatment be funded.

We have every confidence that PHARMAC approached this work with the normal open mind and rigor we expect from it as our national manager of medicines funding.

This rigor, while sometimes leading to disappointment for some people when decisions are made, ensures that whatever amount of money is spent on medicines is spent wisely and to maximise health outcomes for all New Zealanders. PHARMAC’s role is a critical one to our health system, but in the DHB experience its benefits are generally undervalued. PHARMAC continually improves access to medicines while at the same time saving New Zealand many millions of dollars each year.

For each DHB, there are always many more projects to help improve health than money to go round, whatever the level of funding. That is a dilemma – how best to spend resources – that most people understand. But people also expect spending choices to be carefully made and money invested when we have confidence that positive outcomes will be achieved.

DHBS are willing and prepared to revisit this situation. We remain open to receipt of new information and advice about the relative benefits and costs of 12 month treatments compared with the current fully funded 9 week treatment. We have every confidence that PHARMAC is open minded and will give any new evidence the careful attention that it deserves.


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