Opinion: Two mums fighting Pharmac over anti-depressant switch should have been heard long ago

Nothing spells 'mental health stigma' like the appearance of two nervous mums at Parliament this week.

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Pharmac’s switch to Enlafax one year ago saves the drug buying agency $5.4million per year. Source: 1 NEWS

At a time when mental health could not be under a fiercer spotlight, cue Trudi Webber and Sarah Macraes' appointment with the Health Select Committee on Wednesday.

In 2017, both women suffered potentially life-threatening relapses into chronic depression after a change in their medication.

They believe it was the result of a brand switch by Pharmac that saw the generic anti-depressant Enlafax replace other medications as the publicly funded option.

It turns out Trudi and Sarah were not alone – an online support group has logged hundreds of negative reactions to the new drug.

The national Centre for Adverse Reactions Monitoring has received 562 negative impact reports so far from doctors and patients.

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Pharmac’s switch to Enlafax one year ago saves the drug buying agency $5.4million per year. Source: 1 NEWS

1 NEWS has spoken to a number of patients, doctors and psychiatrists who are concerned about its side effects.

From the outset Pharmac, Medsafe and the Ministry of Health have maintained that Enlafax is a carbon copy of the drug it replaced.

It has the same active ingredient in the same quantity – it is therefore bioequivalent. Medsafe also claims it expects around one per cent of patients to experience adverse reactions to a brand switch.

That equates to around 450 patients negatively affected among the estimated 45,000 New Zealanders on Enlafax.

This is the point where the world of Pharmac and Medsafe collides head-on with the world of Trudi and Sarah.

There is a vast gulf between science-based drug funding and patients who have dragged themselves back from the brink of despair.

This was clear for all to see at Wednesday’s Select Committee meeting, which the Ministry of Health and Medsafe also attended.

The backing of science enables authorities to chip away at patient credibility – with claims there is often resistance to change and negative symptoms may be psychosomatic.

It enables authorities to maintain that despite 562 adverse reports there is no safety or quality issue with the drug.

It enables authorities to label serious issues like the threat of patient suicide as "within the expected adverse reaction range.”

Whether it is intentional or not, it also enables authorities to avoid directly addressing the concerns raised by people like Trudi and Sarah.

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Pharmac says it followed standard procedure changing from Effexor X-R to Enlafax. Source: 1 NEWS

For their part, Trudi and Sarah weren’t arguing about the quality of the generic drug or the medical data and cost savings that support its introduction. Their key issue is the care of patients who rely on medication for their emotional stability and wellbeing.

The positive news is that the Select Committee does seem open to addressing Trudi and Sarah’s concerns. They want changes around brand switches of psychotropic drugs to ensure better patient monitoring and information.

The Committee has also called on Pharmac to appear.

Those reliant on anti-depressants will be watching developments very closely. But it remains hard to fathom how two intelligent women had to go through so much simply to be heard.