Patients 'distressed' at switch to cheaper cancer drug

The National Party claimed yesterday that up to 25 cancer patients in Auckland were in anguish because the drug they were being successfully treated with was suddenly replaced with a cheaper one in a cost-cutting measure.

Health Minister Annette King says she was advised that the decision was based on strong international evidence that that there was no additional benefit from using the more expensive drug.

Auckland Hospital manager Nigel Murray said that the drugs in question were not life-extending treatments but helped in bone-related symptoms of cancer.

And in fact, neither drug was available for a short time while the waiting list of 20 was cleared for patients waiting for life-extending chemotherapy.

"It's about prioritisation and making sure that the patients who benefit the most are treated first.

"I just have to treat those, rightly so, whose lives will be extended."

He said the hospital had tired to contact all patients before they came due for their treatment but he conceded that notifications had not been "optimal".

The National Party health spokesman, Paul Hutchison, raised in Parliament yesterday the case of two women, with their permission, Frances Borich of Kemeu, and Winifred van't Hoff of Papakura.

The women were having treatment for secondary cancer of the bone, originally having breast cancer.

He tabled letters from Winifred Van't Hof and the son and daughter of Mrs Borich describing the distress of the patients at having their chemotherapy changed last month from Zometa to Aredia, administered every four weeks.

Mrs Borich was told when she turned up for Zometa that it would be her last and that she might have to wait another 18 weeks for her next appointment.

Dr Hutchison said it was "inhuman and callous." It also took five times longer to administer the cheaper drug _ two and a half hours _ and thereby reduced the number of patients who could be treated.

"It increases costs to the hospital and it causes despair and anguish to cancer patients."

Winifred Van't Hof said that discontinuing Zometa was a "false economy" and was putting delicate serious health conditions in more danger.

Her illness, body and mind were used to Zometa. "It works well and is very effective ... It is bad to 'rock the boat' with cancer," she wrote.

Michael Borich complained to Auckland Hospital that: "Taking away a beneficial treatment has left my mother feeling crushed."

Annette King said it was not for her to decide which cancer drugs patients would receive.

"The Auckland District Health Board carefully considers the range of treatment options for patients with cancer and, as a consequence, it regularly reviews its decisions."

She had been informed that the two drugs had been assessed by expert cancer treatments subcommittee of the Pharmaceutical Therapeutic Advisory Committee, which advises Pharmac on drug efficacy.

It concluded that both drugs had similar efficacy but that Zometa was considerably more expensive "and their minutes note that this higher cost cannot be justified."

Dr Murray said last night that the more costly drug could be infused in about half an hour and the cheaper one in about two and a half hours. For some patients that could create an inconvenience "but it does not create a clinical difference."

But neither would be used until the waiting-list was cut for those requiring life-extending chemotherapy.

Dr Murray said that before Christmas the waiting list for life-extending chemotherapy was 160 and it was now down to 20 "thanks to the outstanding efforts of our cancer services."

"They have been working night and day to get this down."

The waiting list had been created by a shortage of expert chemotherapy nurses.