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Pharmac is open to funding a longer treatment regimen of breast cancer drug Herceptin if there is evidence it would achieve the best health outcomes, Pharmac's boss said.
His comments yesterday came after the release of a High Court decision ordering Pharmac to review its decision not to fund 12-month Herceptin programmes.
In 2006, the government drug-buying agency decided against spending up to $30 million a year for the 12-month Herceptin programme for women with the aggressive HER2 positive form of breast cancer.
It instead allocated $5 million a year to allow suitable patients to undergo a nine-week course. Pharmac also decided to budget $3.2 million towards participating in an international short- or long-duration (sold) trial of Herceptin and has begun making payments.
Pharmac acting chief executive Matthew Brougham said the High Court decision gave the public "significant reassurances" about Pharmac's processes and decision making.
"Pharmac needs to carefully consider the judgment before taking any steps. This includes considering the wider implications for Pharmac's decision making."
He acknowledged the court said Pharmac should have consulted on its decision not to fund the 12-month programme.
"Pharmac remains open to funding a longer treatment regimen ... if evidence suggests that it, relative to other medicines that could be funded, would achieve the best health outcomes for New Zealanders."
Eight breast cancer patients, dubbed the "Herceptin Heroines", banded together and with lawyer Helen Cull QC approached the High Court to have Pharmac's 2006 decision quashed. They also sought to reverse the decision not to make special funding available for their own treatment.
One of the eight, Christine Mary Miriam Walsh, said she was delighted Pharmac would now have to "do its job properly".
She said a review of the 12-month course was the main goal.
"Everything else is inextricably linked in many ways. So we're absolutely delighted and it really vindicates us, the oncology community and the public.
"If they do their consultation properly there will be a wide-ranging input into this and part of that will include the evidence that [supports] the 12 months ... If you take that into account and all the consumer consultation it will be really interesting to see Pharmac's response to that. And I don't think they can come back and say 'it doesn't matter, we haven't got the money'.
"You may as well not have evidence and you may as well not have advisory committees if you are just going to say 'we haven't got the money'."
Justice Warwick Gendall agreed with the women's claim that Pharmac had not undertaken proper consultation before rejecting the 12-month programme.
His judgment directed Pharmac to reconsider that decision after conducting full and open consultation, but warned the outcome may be "precisely the same".
As Pharmac had already done extensive research while contemplating the nine-week trial, the consultation "should be undertaken with speed," Justice Gendall said.
The women's request to have the nine-week courses blocked was denied, as was their request to have Pharmac make special funding available for their own treatment.
Drug company Roche Products' managing director Svend Petersen said 32 countries fund Herceptin and New Zealand remained the only developed country to have declined funding 12-month programmes.
Pharmac reviewed the same clinical evidence as the 32 other countries but came to a different conclusion, Mr Petersen said.
"We remain concerned that funding decisions on innovative new medicines like Herceptin may be unfairly biased by their budget impact.
"In countries with similar health systems, such as the United Kingdom and Australia, the clinical and cost-effectiveness review of medicines is conducted separately to the assessment of budget impact."
Health Minister David Cunliffe and Associate Health Minister Steve Chadwick said they respected the High Court's decision.
National Party associate health spokeswoman Jackie Blue said the decision was a "well-deserved slap in the face" for Pharmac. The former breast physician said she was pleased the agency was being held to account for failing to consult properly.
- NZPA
