Consultation could never change Herceptin evidence
7 August 2008
Consultation could never change the evidence for Herceptin
“PHARMAC’s decision to continue funding the nine week regime for Herceptin and not the twelve month regime for women with early stage breast cancer is a brave and difficuIt decision, but sadly it is the right one.” Says Jo Fitzpatrick, Director of Women’s Health Action Trust. Ms Fitzpatrick says her organisation entered the Herceptin debate reluctantly but did so because of concern at the high level of public misunderstanding about the drug and its effects.
‘Herceptin is promoted as the magic bullet for early breast cancer treatment. People used to think – and many still do – that HER2 positive breast cancer can and will be cured by Herceptin. We wish that was true but the evidence just isn’t there and people need to know that. At its best, 87 women in every 100 taking Herceptin get no benefit from the drug at all and may be harmed by it. “
In recent years as lobbying for 12 month funding has accelerated, the argument is made that New Zealand is ‘behind’ the rest of the world in providing access to Herceptin. We know more about the one year treatment regime because the drug company prefers it. Roche recommends it to Government’s and fund the studies to support these applications. ‘This helps to create a culture where 52 weeks is seen as the ‘norm’ and ‘best practice’ when in fact we just don’t know. Common practice is not best practice: says Ms Fitzpatrick. ’
In a situation where best practice is still being established, which is the case for Herceptin, PHARMAC has made the best decision for New Zealand women – to reduce exposure to the toxic side effects while ensuring access to the drug. All Herceptin regimes are experimental. The shorter nine week course of treatment has similar benefits to longer treatments with less likelihood of toxic side effects.
‘The nine week course offers the best balance between potential benefits and harms for Herceptin. In choosing the nine week course of Herceptin treatment, PHARMAC has made a considered and careful decision.’
‘The Herceptin debate has been intense and clouded by emotion and wishful thinking. This decision will be unpopular and greeted with howls of uninformed outrage.’ Says Jo Fitzpatrick “ But sadly it is right - a considered decision, based on available evidence.”