12-month Herceptin treatment now available
Hon Tony Ryall
Minister of Health
Minister of State Services
10 December 2008 Media Release
12-month Herceptin treatment now available
Health Minister Tony Ryall has welcomed the Prime Minister’s confirmation that a full 12 month course of the breast cancer drug Herceptin is now available.
“Women with early breast cancer responsive to Herceptin will now have the option to access a one-year course of the cancer drug.”
“We are extending funding for Herceptin to allow patients and their doctors to have a choice of a 12 months course. The nine-week treatment option also remains funded and available."
National’s 100 day action plan included making publicly funded Herceptin available for 12 months, and today we are fulfilling that election commitment.
Mr Ryall said, "We expect that over time up to 300 women a year will benefit from the year-long course of Herceptin treatment. This is being funded from the extra $180 million this government plans to spend on pharmaceuticals over the next three years," he added.
Mr Ryall also announced that women who have paid for Herceptin treatment privately between 19 November 2008, when the Government was sworn in, and today can seek reimbursement from the Ministry of Health for the full cost of their treatment.
Patients currently receiving a privately funded course of 12 months Herceptin now have the option of completing the remainder of their treatment with a public provider, where it will be fully funded by the Government. Women may choose to continue receiving treatment privately, although the Government will meet only the cost of the drug until they have completed their treatment. In this case, the costs of delivery will still have to be paid for privately
Patients who recently completed a publicly funded nine-week treatment or recently discontinued a private 12 month course of Herceptin treatment may now be able to receive the balance of a 12 month course of treatment publicly. However, this is subject to their specialist’s clinical judgment.
Mr Ryall acknowledged the assistance of former breast physician, Dr Jackie Blue MP in developing this policy.
Clinical guidance for implementing this funding policy and information for patients are available on: http://www.moh.govt.nz/cancercontrol/
Questions and Answers
1. Who is eligible to receive the 12-month Herceptin treatment?
The 12-month treatment is available to patients eligible to access publicly funded health services in New Zealand who have early breast cancer whose tumours express high levels of HER2 protein and will benefit from treatment.
2. Will the new policy require extra capacity in cancer centres and district health boards?
The new policy will result in an increase in patients attending outpatient clinics to receive treatment. In the long-term, this will require extra staffing and equipment. DHBs have identified the need for additional funding to support these extra requirements. The Government is providing additional funding up to $3.6 million per annum to support the additional costs of administering the drug. The cost of the drug is commercially sensitive.
3. How will the new policy of providing a 12-month regimen affect Pharmac’s existing listing for 9 weeks treatment agreement with Roche?
Pharmac’s listing of Herceptin for funding 9-weeks treatment remains unchanged. Roche and the Ministry of Health have entered into a separate agreement under which the Ministry of Health agrees to fund the 12-month Herceptin treatment.
4. Pharmac previously said that the full 12-month course has no added health benefits and the money is better spent elsewhere. Has the Government’s assessment changed? If so, why?
The benefits of using Herceptin to treat early breast cancer are well known and recognised internationally.
The benefits of Herceptin have been reported in a number of international randomised trials, including the HERA and FinHer trials. Patients in the HERA trial received 12 months of Herceptin, whereas patients in the FinHer trial received nine weeks of Herceptin.
34 other countries around the world offer 12 months Herceptin as the standard of care. The new Government is extending funding to give women with early breast cancer a choice about the length of their treatment, based on their individual needs and circumstances.
5. What is the appropriate interval between completing a nine-week course of Herceptin and commencing the balance of a 12-month course?
Consideration of the appropriate interval should be based on good clinical practice and the individual circumstances of patients. In particular, cancer specialists will take into account the protocol requirements of the HERA trial (an international randomised trial that reported the benefits of Herceptin) and the clinical advice received by the Ministry of Health that recommends an interval of no more than 4-12 weeks. But this is a clinical decision, and women should discuss this with their specialist.
6. A Pharmac review of Herceptin this year found there was greater risk of toxic exposure and heart problems associated with a 12-month course.
Clinical trials have shown that Herceptin has a small risk of significant side effects, such as heart failure, and that this risk may be increased with longer courses. This is one factor that needs to be considered by cancer specialists and women when making a decision about the length of Herceptin treatment.
Safeguards are taken when Herceptin is administered, including regular checks of heart function with an echocardiogram or MUGA scan.
7. Are New Zealand patients still able to participate in the SOLD trial?
Yes. New Zealand patients receiving 9 weeks or 12 months of Herceptin can continue to participate in the SOLD trial. This trial is comparing the effectiveness of 9 weeks and 12 months Herceptin therapy.