Letters: Missing out on cancer drugs

Medsafe is one of the best agencies in the world at registering new medicine, says a reader.

Cancer touches all New Zealanders in some way, and the number of cancer diagnoses is on the rise, with one in three of us likely to be diagnosed in our lifetime.

Giving hope in the fight to beat cancer, new immunotherapy medicines are emerging with better survival data than we've seen before. Yet, because of New Zealand's strict system for funding, many of these essential new medicines are not currently available to all who need them.

As New Zealanders, we should be challenging the new government to ensure cancer is seen as a priority, not only in terms of faster access to specialists and treatment, but also faster access to the most effective medicines. Patients may be getting diagnosed more quickly, but in many cases they are being given treatments that have been superseded in most other countries.

Medsafe is one of the best agencies in the world at registering new medicines. Medsafe's appraisal and approval timelines are consistent with other global regulators, such as the European and Australian agencies.

However, New Zealand is the only OECD country with a capped pharmaceutical budget, and while Pharmac does its best within the existing budget, the trade-off is lack of access to new medicines. A study by Professor Frank Lichtenberg noted that between 2006 and 2010 about 12 per cent of deaths from cancer within five years from diagnosis would have been avoided if cancer survival in New Zealand was the same as Australia.

Every new tumour type must go through the same time-consuming application, committee review, potential re-application, ranking and negotiation process. This leads to long delays and no guarantee of eventual funding. Currently, the average wait time for Pharmac funding is over three years.

Things are very different overseas. For example, in Germany medicines are funded immediately upon registration, followed by a formal reimbursement process that is concluded within one year.

Other countries in Europe have recognised immunotherapies' significant potential to treat multiple cancers, and have taken specific steps to ensure timely access for their citizens.

Closer to home, Australian Health Minister Greg Hunt announced recently that he had asked the Pharmaceutical Benefits Advisory Committee (Australia's Pharmac equivalent) to "find a way" to assess cancer medicines that treat multiple tumours, to help ensure timely patient access.

During the election campaign the New Zealand First Party included a policy to conduct a review of the efficiency and efficacy of Pharmac's operations, and of the adequacy of pharmaceutical funding.

The Labour Party pledged to immediately begin work on an early access to medicines scheme that will give patients access to innovative life-saving new medicines.

The National Party has increased the funding to Pharmac over its term in government.

It appears that all parties have in some way recognised that there is work to be done to improve access to medicines. A boost to the Pharmac budget of just $40 per person, and the introduction of a mechanism for rapid access to break-through new medicines, would mean we truly would have a world-class system for medicines funding in New Zealand.

PAUL SMITH
NZ director, Merck Sharp & Dohme (New Zealand)