Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Thursday, August 14, 2008

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)

Wednesday, August 6, 2008

Drugs

We're not talking the legal kind here, we're looking at where parties stand on illegal drugs - including their record as to how they voted for the ban on party pills. Whatever your stand on drugs - whether you love them or think they're the scourge of society - it's probably a good idea to know which way the wind blows for each of the main parties. First of all I think the best place to start is to look at each party's history. As a case study I'll look at the party pill ban that came into effect earlier this year. Simply put, here's how it breaks down.
Bill introduced by: Jim Anderton (Progressive Party)
Vot
ed for: Labour, National, New Zealand First, United Future.
Voted against
: Green Party, The Maori Party, ACT.
(source: NZHerald)

There are some things I was specifically looking for when researching this article. I wanted to know what drugs the party thought were the problems and I wanted to know what plans and provisions they made for rehabilitation. I looked specifically at Social Policy, Youth Policy, Health Policy and Law and Justice Policy.

So, looking at policies and plans, what have the majors got to say on the drugs issue?

Labour are in the "Drugs are Bad" camp. Their policies are all dated 2005 however there are no specific policies on drugs within the 2005 Labour portfolio. However, they reference P and methamphetamine especially within the Law and Order section of their policies. Labour would like to see an end to the "P made me do it" excuse (think Antonie Dixon) and think that instead of treating this like an excuse, it should be treated as an aggravating factor and only make the punishment harsher. It's worth noting that I can't currently see anything about other drugs or drug rehabilitation.

National also don't like drugs and again, like Labour only really talk about P and methamphetamine. National clump P in with their Gang policies. National want to "clamp down" on P dealers and manufacturers - stopping them from getting bail, handing out tougher sentences and ensuring they see trial. When it comes to the youth of New Zealand, National want to see the Youth Court be able to hand down mandatory rehabilitation programmes (reference: NZ National) Again, no mention of other drugs and with the exception of the youth courts, there is no mention of drug rehabilitation.

The first party I've investigated who even acknowledge the existence of drugs apart from P. The big points in their drug policy are:
  • aggressively target "P" and other dangerous drugs through co-ordinated education and police programmes aimed at reducing both access to and the appeal of these types of drugs
  • oppose all efforts to legalise cannabis and any other form of illicit drugs
Interestingly enough they also want to raise the drinking age. (source: NZ First) One of the lynch-pins in the NZ First ideology they want to "protect [the] social fabric and traditional family values which underpin our society". This means they oppose relaxing laws related to prostitution, cannabis and other drug use, and "other issues that undermine traditional family values". Further, NZ First believe that any changes to these types of policy should be decided by referendum rather than by politicians. NZ First would like to implement roadside drug testing, looking for people driving while under the influence of drugs. It's worth noting that NZ First also clump drugs in with gangs (source: NZ First) and again, I can't find any mention of drug rehabilitation - except for inmates in prison.

Lots of people think that Marijuana Law Reform is the Greens' "big policy" it's not, but frankly they are one of only a few parties actually looking at this issue with any depth. The only other party with a dedicated policy is United Future. The key principles of the Green Drug Reform Policy about sum it up. They recognise that all drug use, regardless of it's legal status can cause harm and that the goal is for drug-free lifestyles. However, they point out that while no drugs are healthy - not all of them are problematic and some current Government policies do not help, but rather create an entirely new set of problems. As far as cannabis goes, this is the skinny on how the Greens actually stand:
  • Their biggest priority is drug education
  • they think medical marijuana is a valid pain relief and want to see it implemented
  • they want people to be able to grow cannabis for personal use - and have limits defined in law
  • they want it to be illegal to drive while stoned
  • they want an 18+ age limit on cannabis use.
The fact that the Greens have a separate policy on this means they are one of the few who have thought beyond the media buzzwords of "P" or "methamphetamine" but the only mention I can find of rehabilitation is within the Youth Affairs Policy.

The Maori Party are thin on the ground on actual policies so we'll look at their ideology, history, and what they've actually said instead . In their Budget Reaction earlier this year, the Maori Party emphasised the amount needed for drug and alcohol rehabilitation. Hooray! This is the first party to actually talk about it for regular Kiwi's who are over the age of 18. Political mud-slinging aside,the Maori Party are also strongly against P.

As I mentioned earlier, the Maori Party voted against making party pills containing BZP illegal, take a look here and read their statement to the speaker. The fact is the Maori Party think it's far more pressing to look at rehabilitation for addicts, support for their families and bringing in tougher controls on alcohol and cigarettes rather than looking at BZP while it is still new on the market and it's effects are pretty much unknown.

The focus of United Future is drugs that are proven by medicine and science to be harmful. Specifically United Future believe that the most harmful substances are methamphetamine (specifically 'P'), cannabis, alcohol and tobacco. They oppose cannabis as a drug for personal use and, like National, want to remove the idea of being under the influence of drugs and/or alcohol as a mitigating factor in sentencing. In a first so far on this post, United Future have quite a comprehensive look at rehabilitation, acknowledging that treatment centres need more funing and they need to be geographically dispersed. Something that (admittedly) surprised me about United Future was the fact they had a seperate Drug Policy (I know, we're supposed to be neutral here but I think this is great, I'm impressed!)

Judging by this page and the fact that Rodney Hide was very much against the ban on BZP I'd take a stab in the dark and say he's not entirely anti-drugs but, to be honest, his website is difficult to navigate and nothing in his "20 Point Plan" specifically addresses drugs.

Aotearoa Legalise Cannabis Party
This website only specifically deals with the "Top 7" political parties from the 2005 election, but just because it's relevant I'm including the Legalise Cannabis Party. These guys put it best in their mission statement
ALCP MISSION STATEMENT
The Aotearoa Legalise Cannabis Party exists to legalise cannabis for recreational, spiritual, medicinal and industrial purposes; to empower people to work together for peace and true justice; and to institute a proper and just balance between the power of the state and the rights and dignity of the individual. We believe adults have the right to freedom of choice unless that choice harms other people or the planet.

POLICY MINIMUM PROGRAMME
  • Immediately tolerate adults’ personal possession and cultivation.
  • Establish regulated R18 cannabis commerce, like alcohol and tobacco. (Policy Council fine tunes ‘best practice’)
  • Make provision for expungement [sic] of cannabis convictions.
  • Establish therapeutic and medicinal applications of cannabis.
  • Enable full-scale cannabis-hemp production and utilisation.

Being fair, the ALCP support rehabilitation but don't mention any other drugs.