"We told you so", medicines industry tells Pharmac
Fri, 04 Apr 2008 03:01p.m.
The High Court's decision on breast cancer drug Herceptin shows that medicine rationing decisions in New Zealand are more about money than clinical effectiveness, the Researched Medicines Industry Association (RMI) says.
In a decision released yesterday the High Court ordered Pharmac to review its decision not to fund 12-month Herceptin programmes.
In 2006 the government drug-buying agency decided against spending up to $30 million a year for the 12-month Herceptin programme for women with the aggressive HER2 positive form of breast cancer.
It instead allocated $5m a year to allow suitable patients to undergo a nine-week course.
Pharmac also decided to budget $3.2 million towards participating in an international short-or-long-duration (SOLD) trial of Herceptin and has begun making payments.
The court said Pharmac had not undertaken proper consultation before rejecting the 12-month programme.
RMI chairwoman Pippa MacKay said today the decision reinforced the view that clinical assessments regarding new medicines for subsidy should be separated from the commercial decisions about the potential price to be paid.
The RMI had previously argued that these two functions be separated.
"Yet, our views, and those of numerous other groups, were glibly passed aside," Dr MacKay said.
Yesterday's decision was a landmark one, she said.
"Pharmac has done an excellent job of rationing medicines in New Zealand, but this decision shows that the rationing processes are more about money than clinical effectiveness.
"We told you so in our submission. We are talking about the quality of life, not just for women with breast cancer, but for the myriad of people with diseases and conditions who are denied the medicines they would get as a matter of course if they lived in another developed country, like Australia."
Yesterday Pharmac acting chief executive Matthew Brougham said Pharmac remained open to funding a longer treatment regimen if there was evidence it would achieve the best health outcomes.
He said Pharmac needed to carefully consider the judgment before taking any steps.
Eight breast cancer patients, dubbed the "Herceptin Heroines", banded together and with lawyer Helen Cull QC approached the High Court to have Pharmac's 2006 decision quashed.
They also sought to reverse the decision not to make special funding available for their own treatment.
Justice Warwick Gendall agreed with the women's claim that Pharmac had not undertaken proper consultation before rejecting the 12-month programme.
He directed Pharmac to reconsider that decision after conducting full and open consultation, but warned the outcome may be "precisely the same".
As Pharmac had already done extensive research while contemplating the nine-week trial, the consultation "should be undertaken with speed," Justice Gendall said.
The women's request to have the nine-week courses blocked was denied as was their request to have Pharmac make special funding available for their own treatment.
NZPA