Major Incorrect Fact in the Annual Review of Pharmac
28/03/2019
Today the Health Select Committee (HSC) released their 2017/2018 Annual Review of PHARMAC (1) Sadly, and
disappointingly, it is factually incorrect.
The review makes the following statement in relation to the petitions Metavivors (a group of people with advanced breast
cancer) presented to the HSC for the funding of the breast cancer drugs Ibrance and Kadcyla: “We heard that the
medicines in question are currently funded for people who have not already received another hormonal treatment for
metastatic breast cancer.”
The very reason we made submissions to the HSC is because these two drugs are NOT FUNDED by PHARMAC and as of today this
remains the case. Currently the funding application for Ibrance has received a positive recommendation by the Cancer
Treatments Subcommittee (CaTSOP) in September 2018 for first line treatment for women who are yet to receive hormonal
treatment for metastatic breast cancer and the Pharmaceutical and Therapeutics Advisory Committee (PTAC) that met in
February this year are yet to release their recommendation. It is this committee that makes the decision whether or not
to send the drug forward to the funding committee. The funding committee then makes the final decision – which is likely
to be several months away. With regard to Kadcyla, CaTSOP decided the drug was not relevant to New Zealand as the
evidence did not assess the use of the drug after treatment with Perjeta. However, CaTSOP did recommend the drug be
funded for a small number of people who are yet to receive Perjeta. This recommendation was also to be considered at the
February meeting of PTAC.
Despite both recommendations being disputed by internationally renowned oncologists, and that the majority of women with
metastatic breast cancer in New Zealand would be denied the two drugs under the current recommendations made by CaTSOP,
the fact remains that the statement provided by the HSC is factually incorrect. This is why women presented to the HSC
over the duration of two days in March this year.
Furthermore, Metavivors are extremely concerned that the HSC are relying upon an internal review of PHARMAC to improve a
number of issues that have been highlighted by Metavivors. The HSC state “Pharmac will report on its progress to the
Minister of Health. We look forward to hearing the outcome of the [internal] review.” Metavivors have repeatedly called
upon the HSC to conduct an inquiry throughout the HSC process and raised concerns regarding continued statements made by
the Minister of Health that he does not support an inquiry into PHARMAC. Such comments call into question the
impartiality and integrity of the HSC, a committee that is supposed to act as a ‘watchdog’ over the actions of PHARMAC
and the Minister.
Finally, Metavivors are alarmed that the auditors graded PHARMAC’s management control environment as “very good” and
performance information and associated systems and controls as being “good”. This is contrary to the evidence presented
by the Metavivors and the now constant stream of media articles of advanced cancer patients relying on Givealittle pages
to financially support their need for medicines that should be subsidised by PHARMAC. As many Metavivors remarked during
the HSC process, the key performance indicators of PHARMAC are almost solely orientated on the budget and spend of the
organisation. Even the HSC heard first hand that when it comes to measuring health outcomes that the national cancer
registry that is administered by the Ministry of Health does not collate data by stage. Therefore, the Ministry and
PHARMAC have no way of providing information about how long advanced cancer patients live for in New Zealand from the
date of diagnosis. This should be of major concern to all New Zealanders as we are essentially ‘flying blind’ in
assessing the effectiveness of PHARMAC when it comes to medicines provided for advanced cancer patients. However, a
report (2) released by the Breast Cancer Foundation states that the median from diagnosis to death from advanced breast
cancer in New Zealand is 16 months, as compared to 3 to 5 years in other developed countries.
We continue to advocate for an independent inquiry into PHARMAC, particularly in light of the incorrect information they
have repeatedly presented to the HSC and media.
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