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Setting the record straight on Herceptin

December 14, 2015

Setting the record straight on Herceptin

Roche Products NZ dismisses Health Minister Jonathan Coleman’s statement on TV3’s Paul Henry show on Friday, December 11 suggesting that a nine-week course of Herceptin® (trastuzumab) is “just as good as a 52-week” course. Medsafe has not approved nine weeks of Herceptin for early breast cancer. There are no rigorous data to support this treatment duration.

Indeed, international guidelines recognise that one year of Herceptin, in addition to adjuvant chemotherapy, is the current standard of care for women with HER2-positive early breast cancer[1].

It is irresponsible of the Health Minister to suggest that women receiving Herceptin today are being prescribed the wrong duration of treatment. Thankfully, cancer specialists in New Zealand and around the world know better.

It is a concern that the Minister misrepresents the role of PHARMAC in assessing new medicines. The overall responsibility for determining efficacy and safety resides with the New Zealand regulator, Medsafe. PHARMAC’s role is to allocate funding within the constraints of their medicine budget. The current debate regarding funding for medicines in melanoma, breast cancer and many other conditions highlights a key problem.

PHARMAC is underfunded.

PHARMAC budget increases over the past ten years have not kept pace with inflation and population growth. Advanced drugs don’t receive funding and New Zealanders miss out. New Zealand ranked 19 out of 20 OECD countries in access to first-class medicines, listing only 11% of these medicines during the period 2009-2014[2].

As Paul Henry rightly acknowledged, while PHARMAC and its subcommittees slowly assess these ground-breaking medicines, New Zealanders continue to suffer. Despite the Minister’s comments on Friday, for patients with breast cancer the unmet need is significant. It is estimated that approximately 180 women per year will die from metastatic HER2-positive breast cancer. Herceptin has changed the lives of many breast cancer sufferers but more recent advances, such as Perjeta® (pertuzumab), are still languishing on PHARMAC’s priority list.

Like treatments for metastatic melanoma, Perjeta is currently fully funded in both Australia and the UK and their positive decisions were definitive and swift. This drug has been registered with Medsafe for 29 months. PHARMAC’s slow decision making is not about effectiveness or safety but one of budget. In addition to Perjeta, there are up to 35 medicines awaiting funding in New Zealand after receiving positive recommendations from their evaluation committee PTAC.

The Minister stated that even countries “in terrible financial situations” are funding the next generation of cancer therapies. So why does New Zealand, a country with a budget surplus, not step up and serve its people in need?


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