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PHARMAC Herceptin Decision Accepted - Ministry.

7 August 2008

PHARMAC Herceptin Decision Accepted - Ministry.

Given the number of important questions about the best use of Herceptin that remain to be answered, the Ministry accepts as a good result PHARMAC's decision to continue to fund the concurrent nine week course of Herceptin chemotherapy treatment rather than twelve months.

National Clinical Director of the Cancer Control Programme Dr John Childs says many clinicians would welcome the certainty the decision brings as it allows them to continue without disruption the treatment programmes of the 250 women here already approved for Herceptin treatment.

"We know that there remain some very important questions around the best way to use Herceptin. The question about whether Herceptin should be given at the same time as other chemotherapy drugs or following other drug treatment is not expected to be more clearly answered for a number of years."

In New Zealand the funded treatment is standard adjuvant chemotherapy for breast cancer which is given at the same time as Herceptin (Herceptin is an additional anticancer drug). This is a reasonable approach based on the limited information we have from the published studies to date.

The question about the optimal (best) length of time for treatment is not yet answered. In the absence of more definitive answers from large scale trials, it is prudent for PHARMAC to continue to opt for the 9 week course of treatment.

"I am personally involved with the treatment of women with breast cancer who are receiving Herceptin along with other usual treatments and they are frequently accepting of the shorter course of treatment - which on balance appears to offer similar benefits and with potentially fewer harms compared to the longer courses of Herceptin treatment."

Dr Childs says the Ministry has quite rightly been separate from PHARMAC's decision-making on this issue. The PHARMAC process is both independent and robust.

"Many health professionals working with patients with cancer are incredibly passionate about doing the best for their patients. That means at times there is very vigorous debate about difficult judgement calls on what constitutes optimal treatments. This debate is healthy, though at times to the general public it can seem complex and on occasion make patient treatment decisions even more difficult."

"There are many day-to-day pressures within cancer control treatment programmes and it is important that the changing mix of treatments work as well as possible within our overall framework."

Dr Childs says any discussion about breast cancer should always include some advice about steps women can take to keep themselves well. For women aged between 45 and 69 that include ensuring they're part of the national breast screening programme and having a regular screen every two years.

"This is the best protection for finding early and treating breast cancer.

With advances in treatments a majority of women diagnosed with breast cancer can be treated and continue to lead productive, happy and full lives.


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