How much does a life cost? And how much is too much?
That's the impossible question policymakers are faced with as the number of Kiwis being diagnosed with cancer rises steadily and desperate patients resort to asking strangers for money for expensive treatments that may save their lives.
This year, more than 20,000 people will have a cancer diagnosis registered, and about 9000 will die.
According to a report in the New Zealand Herald, desperate patients are turning to crowd-funding sites like Givealittle in the hope of raising money for non-funded treatments. This year alone, more than 650 appeals have been started by patients, or their friends and family, who have nowhere else to turn.
Our cancer death rate is higher than the average for developed countries. If our rate matched Australia - where some drugs such as Keytruda are state-funded - about 700 fewer New Zealanders would die of cancer each year.
But Health Minister Jonathan Coleman cites Pharmac research findings that, of 22 cancer medicines funded in Australia but not NZ, only one clearly exceeded international thresholds for clinically meaningful gains and that drug was being considered by Pharmac.
It indicates the country is not missing opportunities to consider potentially useful treatments and is avoiding significant expenditure on cancer medicines that are either unable to provide a supporting evidence base, are potentially harmful versus standard care, or offer low health gain, he says.
He also points to the fact that the Government had spent nearly $63 million since 2008 on its faster cancer treatment programme.
It is a sound argument given the cost of the treatments. Cancer has a devastating impact on families and most people have been touched by it in some way.
In an ideal world these treatments would be funded and there would be no need for people to have to put out public appeals to help fund their treatments. However, the money has to come from somewhere.
The Government needs to be judicious about how it uses taxpayer funds and has to ensure that the money it does spend has the biggest impact.