Cancer has been in the news nearly every other day during 2019. There is good reason for that as cancer is the leading cause of death in New Zealand with more than 23,000 people diagnosed and more than 9600 Kiwis succumbing to the disease last year.
With Daffodil Day approaching it is a good time to reflect on some of the key cancer issues facing us as New Zealanders.
It is predicted - due to an increasing and aging population - cancer diagnoses will increase by 50 per cent by 2030 so there is a clear need for a new more integrated way of planning and delivering cancer screening, diagnosis and treatment services across New Zealand.
There are more than 100 licensed medicines on Pharmac's waiting list for funding while the UK drug funding agency NICE doesn't have a waiting list.
The Cancer at a Crossroads conference at the start of the year brought together clinicians, DHBs, the Ministry of Health (MOH), PHARMAC and NGOs like the Cancer Society to discuss the many issues surrounding cancer such as screening, diagnosis and treatment. Speaker after speaker highlighted the inequity of available services and the postcode lottery people face when for cancer treatment, which varies depending on where you live.
Dying cancer patient Blair Vining, who has been in the public eye this year, also made a presentation at this audience which included the Minister of Health. He also presented a petition with more than 140,000 signatures to Parliament asking for a National Cancer Agency.
The Cancer Society has strongly been advocating for strong central leadership, free from political interference, clear treatment standards, and a way to ensure consistent care is at the core of the plan.
The current Government, while in opposition, promised a national cancer agency and has yet to deliver. The current opposition has also promised one should they be elected next year. The Government is due to announce a "national cancer plan" this week and the Cancer Society is very keen to see what it contains, especially about how it will address the equity issue.
The inequity of cancer treatment and health outcomes is clearly demonstrated in our own region of Auckland Northland. Northland has a higher incidence of cancer and a higher mortality rate compared to New Zealand as a whole. Maori are disproportionately affected by cancer with the incidence of cancer 27 per cent higher for Maori than non-Maori.
People outside of Whangarei have needs compounded by distance, poverty and disconnected services. Many cancer patients from Northland must travel to Auckland for radiotherapy and some chemotherapy treatments. Some of these treatments can last for weeks at a time. There is a National Travel Assistance scheme run by the Ministry of Health. However, this scheme was developed in 2006 and the financial support available through the scheme not increased since. The tough eligibility criteria mean that many people miss out. The system is well overdue for an overhaul.
Much of the media on cancer issues this year has focussed on funding of cancer medicines. This, of course, is just one part of the battle against cancer, which also includes health promotion, better diet and lifestyle choices, quitting smoking, cutting back on the booze and doing regular exercise. But access to drugs has become a galvanising issue that has led to numerous public rallies and marches to Parliament.
Just last week it was reported New Zealand has fallen to the bottom of the OECD for access to medicines - taking twice as long to publicly fund medicine compared to other OECD countries.
It is not okay that people must mortgage their homes or set up Givealittle pages to afford life-saving treatments. While the Pharmac model has worked in saving the government money in the past, it is not keeping up with funding proven, licensed cancer treatments in the same way as comparative countries such as Australia, the UK or Canada.
A recent visit to New Zealand by UK drug approval agency NICE chief executive Sir Andrew Dillon demonstrated a dramatic difference in the two countriesto access to cancer drugs.
While there are over 100 licensed medicines on Pharmac's waiting list for funding, NICE doesn't have a waiting list. NICE responds to most applications within 90 days of a new drug gaining a licence to be marketed and approves about 80 per cent of these applications. That way the drugs can be used straight away by people who need them and are further assessed in everyday use.
Further, there is a special fund in the UK called the "Cancer Drugs Fund" which can provide early access to drugs under certain conditions such as additional reporting, which means earlier access for patients to these medicines.
The Cancer Society is advocating for a similar approach in New Zealand with an "early access to medicines scheme", allowing patients to receive breakthrough new cancer drugs where these are registered by Medsafe, but not yet funded through the normal Pharmac process. People with advanced cancer simply can't wait for the usual process to take its course and require access to these treatments now to survive.
This will require a willingness from the Government to make substantive change to the way Pharmac works and to fund this appropriately.
The theme of this year's Daffodil Day is "Change for Better" and is a call for change and an
investment in a better future. Your generosity of Daffodil Day makes it possible for the Cancer Society to be a strong, impartial voice to improve cancer outcomes in New Zealand. It also funds important education and prevention campaigns as well as vital cancer research right here in New Zealand.
I hope all New Zealanders support Daffodil Day this Friday through donations so the Cancer Society can continue to be a leading advocate for the one in three Kiwis who will be affected by this dreaded disease. You can donate on-line at www.daffodilday.org.nz.
• Andrew Young is the chief executive officer of the Cancer Society Auckland Northland