KEY POINTS:
Government drug funding agency Pharmac will today move in the High Court at Wellington to refute claims by eight breast cancer patients challenging its decision to fund nine-week treatments, rather than 12-months of the expensive drug Herceptin.
A lawyer for Pharmac, Mike Colson, late yesterday opened the agency's defence against the womens' bid to quash two key decisions on funding the drug.
The group of women has claimed that in 2006, Pharmac decided not to spend up to $30 million a year to fund 12 months of Herceptin treatment for those with aggressive early breast cancer, and instead decided in 2007 to spend $5m a year on a nine-week courses for suitable NZ patients.
The women, who refer to themselves as "Herceptin Heroines", also want the judicial review to overturn Pharmac's rejection of applications for "exceptional circumstances" funding of their own treatments.
Some of the women paid up to $120,000 for their own supplies of the drug, but others were not able to afford a full 12-month treatment.
Mr Colson said that, contrary to statements by the plaintiffs, Pharmac's board did not specify on July 28, 2008, that it was declining funding for 12-month courses of Herceptin - it only said it would not fund the drug of early-stage HER2 breast cancer at that point.
The allegation of that Pharmac specifically blocked 12-month treatments has been a key platform in the case argued on behalf of the women by barrister Helen Cull, QC.
"There was no reference ... to the 12-month's treatment regime being declined," Mr Colson said.
He also disputed the second of three key claims by the women in their case to have Pharmac decisions quashed. In addition to wanting to void Pharmac's May 2007 decision to fund nine-week treatments, the women have opposed a Pharmac decision to spend $3.2 million on a clinical trial (known as SOLD) comparing the short or long duration courses.
But Mr Colson said their actual request to the court for relief failed to include the decision on the SOLD study.
"I was a little surprised to hear (in court) that was the subject of an application to quash the decision," he said.
Justice Warwick Gendall has several times during the case questioned how the women could seek to stop a study in which they were not participants, and what should be done about the dozens and dozens of women benefiting from the nine-week treatments if they lost Government funding of the expensive drug.
In his first 30 minutes of argument in the case, which is halfway through the seven days hearing for which it was set down, Mr Colson also countered a claim by Ms Cull that the Pharmac board did not sight minutes from a specialist cancer sub-committee which commented favourably on the 12-month regime. He showed the court a record of the minutes being included in papers which went to the board.
And Mr Colson explained that though women with HER2 breast cancers which have spread can have 12-month treatments of Herceptin, Pharmac had never assessed the costs and benefits. Instead the 12 month treatments were a legacy from the "postcode prescribing" up to 2001, when health boards had varying policies on funding cancer drugs, and women were able "move" to district with the easiest funding regimes.
The 12-month provision of Herceptin for metastatic cancer was carried over in an "oncology basket" of drugs hospitals were then required to provide. In fact, the drug is only made available to those patients until the disease progresses further and there is no point to continued treatment.
- NZPA
