Herceptin

If you try to keep an eye on the news you've probably heard the word Herceptin. You might be aware that it's a drug used for treating cancer - you might even know that it's especially for breast cancer. Perhaps you've learnt that recently, Pharmac (the state-owned drug buying company) turned down an appeal by former breast cancer sufferers to extend the state funding of Herceptin from 9 weeks to 12 months and that this has made many breast cancer sufferers (and their families) very upset.

Not being a cancer sufferer myself I don't know much about cancer treatment and Herceptin itself so I went on a bit of a fact-finding mission. Herceptin is a biological treatment. Essentially this means that it uses natural substances to get the body to attack the cancer cells in certain breast cancer types. Only about 15-25% of breast cancer sufferers will respond to Herceptin treatment as they have to have a particular kind of breast cancer (HER2 positive)

The biggest debate in New Zealand right now is whether to fund a full 12-month course of Herceptin for eligible patients or to stay with the current 9-week course. Looking at the facts: -

• Pharmac (the New Zealand drug funding agency) has opted, twice, to only fund the 9-week course.
• The cost of a 9-week course per patient is $13,000 making a total annual cost of ~$6 million.
• The cost of a 12-onth course per patient is $71,000 making a total annual cost of ~$25 million.
• There is evidence to suggest that, rather than being the wonder drug it has been touted to be, Herceptin is only really effective in about 13% of patients.
• Further, there is no evidence to suggest that a 12-month course is any more effective than a 9-week course.
• Herceptin also carries a pretty heavy side effect - it seriously weakens the patients heart.
  

The reason it's such a big deal right now is because cancer is an emotional issue. Faced with the prospect of death - whether it's your own or a close family member's - people panic. 12 months seems like a better idea than 9 weeks so why not have the full treatment option. Further, New Zealand is one of only three OECD countries to not fund the full 12-month treatment - the other two being Turkey and Mexico. Ultimately much of the focus of the media around this issue has been focused on cost. The scientific evidence points to there being no difference between the two treatment options except that the heart problems are reduced with the 9-week course due to the fact that it's (obviously) shorter.

So, now that you've got the background on the issue, what path do the top seven political parties want Pharmac to take?

Labour
Are supporting Pharmac's decision with the Health Minister David Cunliffe saying that he can't lawfully direct Pharmac to fund anything.

National
Support the 12-month course. They criticise Pharmac for withholding the 12-month scheme blaming the health budget.

NZ First
Support the 12-month course. Winston Peters has labelled the move "a disgrace which is denying New Zealand women an internationally standard treatment"

Green
Support Pharmac (and therefore the 9-week course) saying "politicians do not have the clinical expertise to make decisions about which drugs to fund. However much we might wish to interfere, we must leave it to the experts to decide."

Maori
There's no information on the Maori Party's reaction to the Pharmac decision however they welcomed the High Court decision to reconsider the extra funding on the basis that the consultation should be transparent.

United Future
United Future has no official, published stand on this issue.

Act
Support the 12 month course. Again, they blame lack of money in the health budget.

RELATED LINKS
Herceptin may not be doing so much for cancer victims (NZ Herald, 16/05/2008)