Will Herceptin Media Blitz Help Or Harm Patients?

Tuesday, 14 February 2006, 5:50 pm
Article: Kevin List

In the last few days there has been a powerful media and political campaign pushing the benefits of the new cancer drug Herceptin. The editor of North and South magazine, Robyn Langwell, devoted her March 2006 editorial to outlining the plight of women who were attempting to raise enough money to undergo a course of Herceptin. Ms Langwell railed in her editorial at the 'tight fisted holders of the Pharmac purse' who she considered were responsible for cancer sufferers being forced to mortgage their homes and beg for money to fund their non Pharmac subsidised treatment.

As well as articles appearing in all of New Zealand's major newspapers, the plight of cancer sufferers was also highlighted on Television New Zealand's 'Close Up' programme.

Yesterday, Pharmac's medical director, Dr Peter Moodie, faced an impassioned 'Close Up' presenter, Susan Wood, who repeatedly asked when Pharmac would be extending its funding for Herceptin to a wider group of breast cancer sufferers than are currently eligible. Dr Moodie was unable to satisfy Ms Wood with the answer she wanted, leading to her suggesting that if she was a cancer sufferer she would be "throwing objects at the TV screen".

One of the prime political movers behind the campaign to make Herceptin more widely available is new National MP Dr Jackie Blue. ( Click here to listen to this Scoop interview.)

Scoop contacted Dr Blue and asked her about any possible side effects Herceptin may have, and also queried her about whether politicians and the media should be putting such enormous pressure on officials to make potentially hasty decisions regarding emotionally charged health issues.

When asked by Scoop why Herceptin was so expensive Dr Blue was uncertain and suggested Scoop contact Roche.

Roche's New Zealand spokesperson Stuart Knight gave this explanation for the more than $100,000 price tag currently being paid by some patients for a course of Herceptin:

"For an average woman the cost of a course of treatment would probably be around 60 to 70 thousand dollars excluding GST. On top of that are private Oncologists costs, administration and monitoring. It will inquire seventeen infusions over a one year period. Charges will vary around the country."

When asked by Scoop why the drug itself cost $70,000 Mr Knight informed Scoop that there was:

"A lot of research and development that had to go into developing the drug."

And that...

"The second major driver of drug price is the cost of manufacturing. Monoclonal antibodies are extraordinarily difficult to reproduce.

"To get to the clinical result we have needed to treat 13,000 women. We are going to needed to follow them up for 10 years. It's a huge commitment on our side," Mr Knight said.

Scoop: Is there anyway of getting a break down into where the costs are?

Stuart Night: "No, we wouldn't go into any more detail than that."

Media and Political Pressure Brought To Bear on NHS in UK

Overseas Herceptin has sparked some debate and controversy - earlier this month a BBC Panorama special questioned whether or not all the claims made by supporters of Herceptin stood up to close scrutiny.

Other BBC reports point out that The Lancet, Britain's long-established and highly-regarded medical journal, questioned just how much was really known about Herceptin.

An editorial raised concerns about the amount of data that existed and what it revealed, about the way the trials had been stopped early, and, most importantly, about the safety of the drug.

In the United States, Federal health authorities have issued warnings about potential heart problems associated with the use of Herceptin.

While the numbers of those who experienced heart problems were very low, a medical expert consulted by Scoop was also critical of some of the claims being made in the media here in New Zealand regarding Herceptin.

Last evening Close Up's Susan Wood stated at the start of her item: "[Herceptin] offers hope because interim trials have shown there is something like a 50% reduction in the risk of the cancer returning."

Wood's claim is inaccurate, according to Professor Les Toop, Department of Public Health and General Practice Christchurch School of Medicine and Health Sciences.

Professor Toop distilled the claim for Scoop stating: "The 50 percent figure is a relative risk reduction as opposed to an 8 - 18 percent absolute risk reduction. By way of a different example, taking a particular osteoporosis treatment may reduce the risk of a fracture in an elderly woman by 50 percent which may sound very impressive. However if her risk without treatment is only 2 percent per year then the 50 percent relative reduction reduces the absolute risk to 1 percent ie; a 1 percent absolute risk reduction. Put another way 100 woman have to take it to prevent one fracture."

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