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An advocate for cancer patients believes the health system is going to be put under more strain and more people will end up in hospital now a funding stream for the treatment of certain cancers isn’t available.
Patient Voice Aotearoa chairman Malcolm Mulholland is disappointed about the situation with two similar drugs used to treat breast and pancreatic cancer patients.
Paclitaxel is funded, while nab-paclitaxel, called abraxane, is unfunded. Abraxane was used by Mulholland’s late wife Wiki, who died from beast cancer in 2021.
Previously patients could pay for a certain amount of abraxane, then start receiving it for free once they reached a funding cap. The Mulhollands paid $25,000 for six months, then it was free.
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The Australian company that makes abraxane, Specalised Therapeutics, had been offering it to New Zealand drug funding agency Phamac for 13 years and allowing the funding cap in the hope it would be funded.
But because the drug hasn’t been funded, Specialised Therapeutics withdrew the capped funding deal on March 1.
“It’s bad news but Pharmac needs to get its A into G and fund this drug,” Mulholland said. “ We’re the only country in the Western world that doesn’t fund it.”
Pharmac wouldn’t comment on the supply of abraxane, but said its role was to prioritise medicines with the available budget.
Mulholland said the only difference between paclitaxel and abraxane, was paclitaxel used a solvent as a binding agent and abraxane used an egg protein, so abraxane was preferred by oncologists because it has better side effects. Nerve damage can be a side effect of paclitaxel.
“There is not that much of a price difference. The unfunded drug costs more, but because of the ongoing health effects with the funded drug, it costs the health system more.
“We have always questioned Pharmac’s funding analysis.”
DAVID UNWIN/STUFF
Wiki Mulholland, who has stage-four breast cancer, speaks to Stuff in 2018 on her fight to have a life-saving drug funded. (First published August 30, 2018)
He said Pharmac looked at the cost of the drug, not how many people were suffering from side effects, and believed more women would be forced to use the funded drug now because they couldn’t afford abraxane.
“For the people affected it would be significant. They’re going to be confronted with a choice.
“They’re going to have to be out of pocket and pay for a drug that is funded in rest of the Western world and you never know how long you’ve got on a particular drug, or take the funded option, which means you will end up in more pain and toddle off to ED.”
Pharmac’s director of operations Lisa Williams said in a statement she was unable to comment on the supply of abraxane or the closure of the patient-access programme, but acknowledged the distress the supplier’s decision could cause for people who may have considered self-funding this treatment.
“Pharmac’s role is to assess and prioritise which funded medicines will deliver the best possible health outcomes for New Zealanders from the budget we have available.
“We use a unique funding model, which is different from the rest of the world. It means we have to make difficult decisions [about] which medicines we chose to fund.”
Fitt said Pharmac had not made any decisions about funding for nab-paclitaxel, but made ranked funding applications for the treatment of pancreatic cancer and breast cancer on its options-for-investment list, which means it was a medicine it wanted to fund, subject to budget.
Factors for consideration included the effect on the individual, whānau and the health system.
“We have re-assessed and re-ranked these applications several times as more information has become available.”
Supplied
Pharmac director of operations Lisa Williams says the organisation’s role is to prioritise funding medicine based on the available budget.
Specialised Therapeutics chief executive Carlo Montagner told Stuff from Australia he had been confident of abraxane being funded and had offered a low price, but the company had to stop the programme in New Zealand because they had been told no by Pharmac and costs were skyrocketing.
About 1000 patients have enrolled in the programme since 2010.
He said it would cost $1.6 to $2.4m to fund the drug each year.
“It’s a global standard of care. For New Zealand to be pretty much the only country in the world that doesn’t reimburse it is amazing.”
After making the decision Montagner sent a letter to New Zealand oncologists and the responses he received were of frustration, disappointment and sadness.
People already on the capped scheme won’t be affected, but new patients will have to pay for it open-endedly.
Gut Cancer Foundation executive officer Liam Willis was also disappointed, as the drug was a treatment option for people with pancreatic cancer.
“This is a group of patients who are increasingly vulnerable, have some of the worst outcomes and have such limited options.
“To see another [treatment option] removed from most people, is really difficult. I feel for the patients.”
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