The fight continues in New Zealand for funding of a life-prolonging drug that targets advanced breast cancer, even as the UK and Australia make moves to have it funded overseas.
Ibrance, which extends life expectancy for breast cancer patients and may improve a woman’s chance of survival, is currently lacking funding in New Zealand due to Pharmac's funding process, health economics consultant Richard Milne said on TVNZ1's Breakfast this morning.
"Over the last few years, we've had a significant delay in funding - two or three years, very often - for good pharmaceuticals," he said. "That's really not acceptable. We need to change the process so the delays will be much less."
To understand the approval process for Pharmac, it's useful to think of drugs as having two properties, he explained.
"First, [there's] the clinical property – does it work on a particular group of patients? And secondly, how cost-effective is it?" he said.
"Cost-effectiveness is determined by clinical effectiveness – does it work? And also by the price and by volume - how many patients do I need to give this drug to? So if you have 500 patients and a very expensive drug, it’s going to be a lot of money for Pharmac."
He said while Ibrance's economic evaluations "look very positive", we must also take under consideration its cost-effectiveness "compared with other drugs that are on the table right now that Pharmac might want to fund".
"It's always the trade-off Pharmac has to make. We've got all these drugs on the table – what do we do with them? How cost-effective are they compared to each other?
The situation's a little different in Australia and the UK, he said, "because they will then take a medicine on its own merits and say, 'Well, how cost-effective is this...drug on its own merits?'...rather than comparatively across the other spectrum.
"There are various new drugs on the table, and the question is, which of these do we fund? Rather than taking away old ones - which can also happen, of course, and does happen – which of the new ones should we fund within the small growth budget that we've had over the last year?"
Mr Milne said he would like to see "some sort of compromise" between the Australian, UK and New Zealand health funding processes.
"I'd like to see...the budget is a little more flexible rather than be absolute - like a billion dollars right now, roughly - a little more flexible to allow more room for new, innovative medicines.
"Let's take another step forward and try to expand the budget to accommodate the very good, effective drugs, rather than creating a delay."
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