KEY POINTS:
Senior doctors advising Pharmac on the implementation of cancer drug Herceptin wanted New Zealand women to receive a 12-month course but were overruled.
The Pharmacology and Therapeutics Advisory Committee (PTAC), comprising 10 senior practising doctors, yesterday recommended that nine weeks' treatment be funded for early stage HER2 breast cancer patients, but only after rejecting the 12-month option.
"We did recommend the 12 months first, and then we were told that was not something we could consider," said Auckland Medical School associate professor Vernon Harvey, one of the oncologists who advised the committee.
Prof Harvey, a PTAC sub-committee member, told Radio New Zealand that "given the choice between nine weeks or nothing", the committee would stick to the nine-week recommendation.
However, patients and their support groups are crying foul, saying that New Zealand women are being offered second-rate care, as overseas trials had proven that a 12 month course of treatment was ideal.
Breast Cancer Aotearoa Coalition chairwoman Libby Burgess condemned PTAC's recommendation as cheap and unethical, and said it was "throwing New Zealand women a few crumbs".
"Pharmac wants to offer New Zealand women with an aggressive form of breast cancer this unproven, cut-price regime while women in Australia, Canada, the UK and 20 other OECD (Organisation for Economic Co-operation and Development) countries are gaining the benefits of a proven 52-week course."
While there is still disagreement about how successful a nine-week treatment would be compared with the more commonly accepted 12-month course, Pharmac has agreed to contribute $3.2 million to an international trial to determine which is the better option.
The trial would be headed by Professor Heikke Joensuu of Finland's University of Helsinki and would start mid-year.
Pharmac has said that the only reason 12 months has become the more accepted course of treatment is because that is what drug manufacturer Roche has licensed it for.
Pharmac deputy medical director Dilky Rasiah said international trials had shown that nine weeks concurrent therapy and 12-month sequential therapy had produced similar results.
As long as there were doubts about which was the best option, Pharmac would support the trial which sought to address the issue.
At least 3000 patients would be needed for a trial of such importance and it would need overseas support, Prof Harvey said.
Patients would be randomly selected to receive either the nine-week or 12-month treatment.
He agreed there was an element of luck involved for participants as to which course they would receive, but said that was the nature of trials and no-one was forced to take part.
- NZPA
