KEY POINTS:
A women's health group has become an unlikely supporter of Pharmac's decision not to extend Herceptin funding from nine weeks to 12 months.
Pharmac's fresh review of the drug's most appropriate course length had "failed to convince us that 12-month treatments offer any additional benefits over the concurrent
nine-week treatment," chief executive Matthew Brougham said.
Women's Health Action Trust director Jo Fitzpatrick "reluctantly" spoke out yesterday in support of the decision, "because of concern at the high level of public misunderstanding about the drug and its effects".
"Herceptin is promoted as the magic bullet for early breast cancer treatment," she said. "People used to think - and many still do - that Her-2 positive breast cancer can and will be cured by Herceptin.
"We wish that was true but the evidence just isn't there and people need to know that. At its best, 87 women in every 100 taking Herceptin get no benefit from the drug at all and may be harmed by it."
The decision means New Zealand is one of just three OECD countries not to fund Herceptin for 12 months - the other non-funding countries being Mexico and Turkey.
It is understood the cost of increasing funding to allow 12-month courses would lift Pharmac's Herceptin bill from about $6 million now to more than $35 million - although Roche Products New Zealand offered a new price "that means it is as cost effective and as affordable as possible", the company's managing director Svend Petersen said.
However, Mr Brougham said the decision was not based on cost, but on a lack of confidence that the expenditure, whatever the exact level, would deliver additional health gains.
"New Zealand's pharmaceutical budget is not bottomless, and it is our duty to ensure that it is well spent. Even if more funding is provided for medicines, we would go through our normal careful process of deciding how best to spend that money to achieve the best health outcomes."
He said evidence which might persuade it to rethink yesterday's decision was still six to eight years away.
"We don't know which one is better - 12 months or nine weeks," he told a press conference in Wellington.
The decision was the hardest in which he had ever been involved.
"It's a very complex area and fraught with a lot of emotion and in my 11 years at Pharmac I have not been involved in anything more arduous."
Health Minister David Cunliffe said he could not legally intervene in the decision, but he had been assured the review had been thorough and the decision had not been made for reasons of cost.
District health boards' spokesman Murray Georgel said the lack of convincing evidence for 12-month treatments meant the decision was one "DHBs can understand".
"In that context, and given the ability of DHBs to improve health through other interventions, it would have been concerning if Pharmac had come to DHBs and asked that the 12-month treatment be funded."
Other groups were scathing of the decision. Breast Cancer Aotearoa Coalition chairwoman Libby Burgess called it "a cruel blow for women and their families".
She said the drug was "life-saving", and Pharmac's decision was "shameful" and "simply inhumane".
National Party associate health spokeswoman Jackie Blue said Her-2 breast cancer sufferers had been "cruelly let down" by Pharmac, and a National government would "free up funds" for the 12-month Herceptin programme.
Act Party health spokeswoman Heather Roy said Act supported the state-funding of Herceptin's 12-month course, and the decision showed New Zealand was "slipping, in terms of prosperity".