Election 2023: Breast cancer patient faces paying $23k every three weeks for unfunded treatment

Ahead of the election, the Bay of Plenty Times is asking Tauranga candidates what they and their party would do to help some of the local people who have shared their struggles and stories with our readers. First up is Sue Wall-Cade: A cancer battler calling for the government to double Pharmac’s budget.

A Tauranga woman with terminal breast cancer may “wipe out” her KiwiSaver account to pay for an unfunded treatment costing about $23,000 every three weeks.

Sue Wall-Cade, 65, is living with stage 4 metastatic breast cancer. She is a “metavivor” - a portmanteau of her terminal diagnosis and survivor.

Wall-Cade told the Bay of Plenty Times she was “probably” on her last funded treatment option — a medication called doxorubicin.

“When that stops working, I will have to be looking at some unfunded treatments.”

Wall-Cade has spoken out ahead of the election to call for medicine funding agency Pharmac’s budget to be “doubled”.

“Things need to happen a hell of a lot faster than what they are. People are having to move to Australia, people are leaving our country because they can’t get what they need.”

In 2018, Wall-Cade started a petition, supported by other Metavivors, calling for better access to life-prolonging drug, Kadcyla. In 2019, Parliament confirmed the drug would be funded.

Tauranga woman Sue Wall-Cade, 65, has stage 4 metastatic breast cancer. She is on her last funded treatment option and will then consider paying thousands of dollars for an unfunded treatment. Photo / Alex Cairns

Wall-Cade said she was diagnosed with stage 2 breast cancer in 2014. She started taking a hormone blocker in 2017, aiming to slow her body’s overproduction of estrogen, but this was unsucessful.

In 2017, she was diagnosed with stage 4 metastatic breast cancer.

Wall-Cade said she had been undergoing chemotherapy for six-and-a-half years.

She and her oncologist were looking at a potentially life-extending drug called Enhertu as an option, but she said she would not be able to keep paying the $23,000 every three weeks it would cost for long.

“It would wipe out my Kiwisaver and then we would have to go into savings.

“I’m really at a point in time where I don’t want to leave my husband with no money.”

She said she would “probably” spend her KiwiSaver then likely stop treatment.

Sue Wall-Cade is considering using her KiwiSaver to pay for an unfunded medication for breast cancer. Photo / Alex Cairns

Wall-Cade said she did not believe the 2021-22 review into Pharmac recommendation to increase the “speed and efficiency” of the process for reviewing and funding medicines had been sufficiently acted on.

“Some of our medicine requests that got on to the list sat there and languish for over five years ... and even when they’re given a priority, it could still be three years before they fund it.”

Approached for response, Pharmac pointed to information on its website showing it received a funding application for Enhertu to treat positive metastatic breast cancer in November 2022.

In April, Pharmac’s Cancer Treatments Advisory Committee recommended it be listed with a “high priority within the context of treatments of malignancy” and subject to certain criteria of the patient.

The application was now under assessment.

Pharmac’s website said it had a process for funding applications to ensure each was treated fairly. Its job was to prioritise which new medicines would deliver the best possible health outcomes for New Zealanders.

It said there were many factors influencing when and if it funded a medicine, including a “clear health benefit”, a deal with a medicine supplier, money to continue funding it and consultation.

A definitive timeframe could not be given for how long it took between an application being lodged and funded.

It said Pharmac managed the Combined Pharmaceutical Budget which was part of the government’s health budget.

“Each year, we aim to spend every dollar of the Combined Pharmaceutical Budget on treatments New Zealanders need. We’re responsible for making sure that medicines, medical devices, vaccines, and related products remain affordable for New Zealand and New Zealanders.”

It said it had been working on increasing transparency and making its funding assessment and decision-making processes faster, clearer and simpler while retaining the robustness of its decisions since 2018.

“We have made good progress, with further improvements to come.”

Tauranga candidate responses

Larry Baldock (Independent)

Hi Sue, your story is very inspiring and heartbreaking at the same time. I do agree that Pharmac funding needs reviewing. Thirty years ago new drugs did not come along as quickly as they do today and by the time their process is followed for funding approval it is tragically too late [for] some of those who could benefit from the new drugs. My commitment to you is that I would do all I could to raise my voice as the MP for Tauranga in support of this important cause and would cast a vote for any significant funding increase.

Justin Crooks (Green Party)

Successive governments have underfunded our healthcare system and left healthcare to private providers. The Greens have a plan to ensure everyone gets the healthcare they need and has enough to live well. We don’t believe you should have to dip into your KiwiSaver to fund the healthcare you need. We would ensure public healthcare is timely and accessible. We would expand public health services and increase funding for Pharmac so it can invest in new medicines. We would also incorporate income support through ACC for health conditions as it’s crucial people can cover life’s essentials, especially when times are tough.

Erika Harvey (New Zealand First)

Dear Sue, as a cancer survivor myself, I understand and can sympathise with your situation and was angry to learn NZ is ranked last in the OECD for market access to modern medicines. If I am lucky enough to make it to Parliament, I promise to be a driving force of change within Pharmac and be a voice for you and others. New Zealand First has committed to increasing funding and is also working with people like Malcolm Mulholland to sort out Pharmac in ways that will have a positive impact for those in similar situations. I’d love to chat further, if interested. Kia Kaha.

Jonathan Langridge (New Conservatives)

I do not pretend to be an expert on cancer and cancer drugs, however, I offer the following general comments. Cancer care can be expensive. One way to reduce the cost is managing the health system better, so early screening, detection and intervention are possible and long waiting times reduce. New Conservatives will reinstate and compensate employees who lost their jobs over Covid-19 mandates and sanctions, including nurses and doctors. New Zealanders are over-taxed, so, we would help ensure Kiwis keep more of what they earn, so people like you can save for their retirement or unforeseen events.

Leon Samuels (Vision New Zealand)

Hi Sue, regarding your personal situation and question, this is our party’s response. While the Government increased the funding to Pharmac over the last two years and with two years to go, it is inadequate at a time when the number of cancer diagnoses continues to increase. If this Government could find $1.4 billion dollars for the Covid-19 vaccine response, and funding needed for supply issues, then increased funding can be found for Pharmac. Vision New Zealand would agree Pharmac funding needs to be doubled and believes Pharmac spending and funding processes need to be far more transparent.

Jan Tinetti (Labour)

Kia ora Sue, as a cancer survivor myself I feel so much aroha for you as you continue to fight this dreaded disease. While it’s Pharmac and not politicians who make decisions on which treatments to fund, health has always been a priority for Labour governments and we have been committed to increasing Pharmac’s funding. Since 2017, Labour has increased Pharmac’s funding by 51 per cent, now sitting at a record $1.4 billion. Labour’s record can be trusted. No politician should weigh into deciding what specific drugs should be funded as this would undermine the independence of Pharmac.

Sam Uffindell (National)

That is a real tragedy and I am very sorry to hear Sue is in this position. National has committed to funding 13 new cancer treatments. We are very focused on ensuring people can receive the treatment they need. National will significantly improve the speed and efficiency for approving medicines. We are much slower than our OECD peers and National will ensure approval rates are improved and consistent with other counties in the OECD.

Christine Young (Act)

Hi Sue, Kiwis like you deserve access to the best treatments available. Act is committed to increasing the availability of medicines in New Zealand. Act will stop the endless waste of money on unnecessary health sector restructuring so there is money available for front-line services and medicines. Act will also focus on lifting New Zealand’s economic performance so that we can afford the medicines and healthcare Kiwis deserve. Act supports the Pharmac review’s call for a medicines strategy that would increase oversight, transparency and improved access to medicines in our health system.

Editor’s note: Submissions may have been edited

Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.