A high-profile Auckland doctor who raised money for her breast cancer treatment at an event where Jacinda Ardern was the emcee says the drug she uses is a "deal-breaker" in terms in benefits.
Ardern ran the event at the Tuning Fork at Spark Arena just after becoming Labour leader in August 2017 to help haematologist and obstetric physician Claire McLintock pay for her $6000 a month Ibrance treatment.
At the time, Ibrance was new to New Zealand. McLintock had begun taking it overseas.
Women with advanced breast cancer are calling for the Government to fund through Pharmac Ibrance and another drug, Kadcyla, which clinical trials show can slow the progression of the disease.
At present, women have to raise around $66,000 for the treatment before it becomes free under a deal with its manufacturer Pfizer.
McLintock is one of those women.
She is still taking Ibrance, calling it a "deal-breaker" in terms of its benefits.
"It's giving me the best opportunity to live as long as possible and have the disease controlled. I feel really well and I am working almost fulltime, I'm president of an international medical association and I can do that and I can travel.
"To me one of the great things about it is, not only is it working - and my disease at the moment seems to be controlled, all the tests show - but I have a really fantastic quality of life," McLintock told the Herald.
Pharmac is still considering whether Ibrance and Kadcyla should be funded. A recommendation is due from its expert advisory committee this month.
But McLintock is clear about its benefits.
"It's not all about how long you live, it's how well you live. People look at me and find it difficult to believe what's wrong with me because I look so well and I live my life and I do my job and I'm still getting to me be in my society.
"That's what I would like for all women, that they get that opportunity.
McLintock said Pharmac needed to reconsider how it assessed new drugs.
"This drug is a deal-breaker in terms of benefit. Maybe it doesn't fulfil the Pharmac criteria as crossing their efficacy barrier but maybe their efficacy barrier needs to be looked at again carefully. That's my personal opinion."
New studies showed that the benefit of Ibrance in terms of progression-free survival was holding up, around 40 per cent benefit over standard treatment.
Avoiding the "massive" psychological blow that followed when the disease came back was hugely important.
"If you can have a therapy that delays that, for me as a patient that's really, really important.
"I know that when Pharmac tries to look at the efficacy of drugs and decide whether or not they're going to fund them, one of the critical things that they focus on is whether or not it prolongs survival.
"The issue with that is that most studies aren't designed look at survival benefit because people generally don't stop treatment. Once one treatment stops working, they go on to another one.
"I think they need to find a new way to be able to assess whether or not a drug is efficacious, and they need to start to find more clever ways to look at quality of life." McLintock said.
Labour repeatedly said while in Opposition that it would consider a scheme, with separate funding to Pharmac, that would give patients early access to new and emerging medicines without going through the sometimes lengthy Pharmac application process.
Despite calls from the likes of former leader Andrew Little and Dame Annette King while she was health spokeswoman and remarks from Health Minister David Clark that it was being looked at, nothing has eventuated.
Ardern has recently raised the issue again, telling reporters she had directed Clark to do more work on an early access scheme.
Ardern, whose mother Laurell battled breast cancer in 2014, told the Herald the personal connections to people who had experienced painful diagnoses had driven the Labour Party to consider a different funding stream for early access to new medicines.
Ardern said she was not alone in knowing a number of women who had experienced painful diagnosis.
"Many New Zealanders know people in these situations. That all too frequent personal connection to people in these circumstances is part of what has driven the Labour Party policy to look at a different funding stream for early access to new medicines, and my recent request to the Minister to expedite that work," she said.
Clark has said that work on how any early access scheme would look was still being done and no advice had so far gone to Ardern.