The Breast Cancer Foundation welcomed the news ribociclib will be funded but says the tight eligibility criteria are "a missed opportunity". (file image) Photo: Getty Images
Patients suffering advanced breast cancer and blood cancer will get free access to two new drugs from July.
Pharmac - Te Pātaka Whaioranga said funding ribociclib (to treat one type of incurable breast cancer) and midostaurin (for acute myeloid leukaemia) - would improve outcomes for hundreds of New Zealanders.
Pharmaceuticals director Geraldine MacGibbon said in the first year, about 400 patients would be eligible for treatment.
"They [these drugs] can help slow down the progression of cancer giving people more time to spend with their whānau."
Under the agreement with the supplier, Novartis, and will be available from 1 July 2024:
- ribociclib (branded as Kisqali) for people with HR-positive, HER2-negative locally advanced or metastatic breast cancer
- midostaurin (branded as Rydapt) for people with de novo acute myeloid leukaemia (AML) that is FLT3 mutation positive
Haematologist Dr Ruth Spearing said midostaurin would be "life changing" for some patients previously given just months to live - and even increase the chance of a cure.
"Acute Myeloid Leukaemia (AML) is a devastating disease which can shorten someone's life to a matter of months unless successfully treated," Dr Spearing said.
"Midostaurin targets the abnormality that is causing the cancer in a sub-group of people with AML who respond poorly to standard treatment. It will be a real advance for us as clinicians to be able to target this abnormality."
It also potentially meant New Zealanders could join clinical trials for even newer treatments, where midostaurin would provide the "standard of care" arm, she said.
"This will advance the cure rate for these patients even further."
The Leukaemia and Blood Cancer Foundation has been lobbying for funded access to midostaurin since 2019.
Chief executive Tim Edmonds said about 130 people were diagnosed with AML every year, of whom about a third had the FLT3 mutation.
"We know, from international studies, that this medicine will aid in the prevention of disease progression and improve outcomes.
"This funding decision takes New Zealand a step closer to providing people with what is considered 'standard of care' internationally. We hope that similar gaps in access to life-saving medicines can be bridged for a wider group of blood cancer people in the near future."
(file image) Photo:
Breast Cancer Foundation says eligibility criteria tight
The Breast Cancer Foundation welcomed the news ribociclib (brand name Kisqali) would be funded but said the tight eligibility criteria were "a missed opportunity".
Spokesperson Adèle Gautier said Pharmac had knocked back the foundation's request, during consultation last year, to allow patients who suffered extreme, life-threatening side-effects to switch to another drug which was already funded.
Ribociclib is the same class of medicine - a CDK4/6 inhibitor - as palbociclib (Ibrance), which has been funded in New Zealand since 2020 following a public petition by 34,000 people.
"Drugs like this work really well for many, sometimes extending survival by several years, so we're really pleased to have another option," Gautier said.
"But some patients are forced to stop a drug due to life-threatening side effects, even though it's doing wonders for their cancer.
"We asked Pharmac to scrap its 'one drug per lifetime rule' for this type of drug to allow patients to switch to another one, which would involve no extra cost and no additional patients, but they've declined that.
"So in that respect, it's falling short and a missed opportunity to do our best for people with advanced breast cancer."
Pharmac considers feedback and special waivers
In response to questions from RNZ, Pharmac's Geraldine MacGibbon said the agency was "still considering" the feedback regarding switching treatments when someone had an adverse reaction.
"We're open to making changes to the eligibility criteria in the future," MacGibbon said.
"We'll be seeking advice on this at a future Cancer Treatments Advisory Committee meeting in 2024 as we need to better understand the impacts of the proposed change."
Meanwhile, the agency would consider special authority waiver applications for anyone who experienced intolerable side effects on either treatment but would otherwise meet the criteria for the other treatment.
"We have updated our notification to make sure this is clear to clinicians, consumer groups, and the public," MacGibbon said.
"We understand it is difficult waiting for a treatment to be funded, and where people would like to see wider access to funded treatments," she said.
"Our team works really hard to make sure that we are funding the best treatments for New Zealanders from within our fixed budget."
