An analysis by Te Aho o Te Kahu, called Understand the Gap, found 20 different gaps in funding medicines between New Zealand and Australia – three of which were curative drugs.
Eighteen cancer treatments publicly funded across the ditch are not available to New Zealanders, despite offering a “substantial” clinical benefit, new analysis has found.
Te Aho o Te Kahu, the Cancer Control Agency, on Thursday released a report comparing the availability of cancer medicines in Aotearoa and Australia, in terms of quantity and clinical benefit.
It identified 20 different gaps (18 individual medicines) – where a cancer medicine was funded in Australia but not in New Zealand – across nine cancer types.
Chief executive Professor Diana Sarfati, said for a number of years there has been concern Aotearoa was “lagging behind” other countries when it came to funding cancer medicines. The analysis aimed to determine how “significant” these gaps were.
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Overall, fewer cancer medicines were funded in Aotearoa than in Australia, both for solid tumours and blood cancers.
Three of the medicine gaps identified were curative: used alongside surgery with the intent to cure a cancer (one for a specific type of breast cancer, the other two for specific types of melanoma).
The other 17 were non-curative: used to either extend and/or improve a person’s quality of life – without the expectation of their cancer will be cured.
Since the analysis, two non-curative drugs (one for a type of lung cancer, one for ovarian cancer) have been approved for Pharmac funding.
Most drugs identified were either being assessed by Pharmac, or had already been assessed.
“When someone is diagnosed with cancer, the first thing they want to know is whether there is a treatment. Whether curative, or life prolonging, people expect to have access to cancer medicines when they need them,” Sarfati said.
Cancer Society co-medical director Dr George Laking (Te Whakatōhea) “greatly welcomed” the report and the increased transparency it offered.
Gaps in medicines availability were not news to the Cancer Society, which routinely hears from patients struggling to privately bankroll unfunded drugs and turning into Givealittle, Laking said.
“We’re feeling the squeeze in cancer, and it’s a price people are paying with their lives.”
Increasing funding was critical – particularly where you’re dealing with “proven” drugs – but you still have to ensure the workforce and environment is “up to speed”, he said.
Pharmac chief executive Sarah Fitt said the report “rightfully identified that there is still work to be done to improve access and outcome equity for New Zealanders affected by cancer.”
Fitt said Pharmac was grateful for the comprehensive analysis, and the opportunity to use it as a resource.
“We would always like to fund more medicines and, with a fixed budget… it’s critical we make sure our healthcare investments achieve the clinical outcomes that meet the needs of and impact the wellbeing of New Zealanders.”
Breast Cancer Foundation chief executive Ah-Leen Rayner said the report was timely, given we are awaiting the overdue findings of the Pharmac review.
However, it disagreed with some of the report’s findings, saying the report – while a “good start” – was “nothing but a missed opportunity to fully ‘understand the gap’”.
The analysis identified a single breast cancer drug available in Australia but not New Zealand. Rayner said they know of at least one other drug recently approved in Australia, and 15 unfunded breast cancer drugs meeting the high-benefit threshold used in the report, it said.
The report medicines concluded were an “integral” part of cancer care, but do not and should not exist in isolation.
“It is clear that the full benefits of cancer medicines can only be realised if the ‘pipeline’ of cancer care (from screening and early detection through diagnosis, staging, treatment, follow-up and supportive care) is working well and equitably. ”
Given the finite resources in health, greater investment in cancer medicines had to be weighed against investment in the workforce and infrastructure, it said.
Stronger cancer prevention and earlier detection were likely to be “the most impactful ways” to address cancer inequities, particularly for Māori and Pacific peoples.