Doctors and skin cancer patients are appalled melanoma drug pembrolizumab won't be funded in New Zealand.
Pharmac says there's not enough evidence to show it works, but oncologists say there's nothing else.
Jeff Paterson's face bears the scars of a six-year battle with melanoma.
To give him a fighting chance his oncologists want to put him on pembrolizumab, also known as Keytruda.
But Pharmac has declined funding for it.
"[It's] disappointing because they used the word low priority and I think it's a very high priority," Mr Paterson says. "Which is terrible to think [and it's] appalling really."
Oncologists disagree with Pharmac's decision, which says there's not enough evidence to show it works.
"The data on pembrolizumab is relatively early but it's very compelling, and it's an area where there are no other effective treatment options available," says oncologist Dr Chris Jackson.
Patients in New Zealand are forced to fund for themselves, despite the evidence being enough to convince Australia and the UK to stump up the cash.
At around $10,000 per patient every three weeks, Pharmac says it's not value for money.
So is the price just too high? Pharmaceutical company Merck Sharp & Dohme doesn't think so.
"We think it's a price that reflects the value of the drug but we're keen to negotiate to get it over the line as quickly as possible," director Paul Smith says.
Pharmac is leaving the door open, saying it will see if the issues can be resolved by getting more evidence or getting a better price. But it could be the wait of a lifetime for patients.
"Time is of the essence and time is something I don't have at the moment, and a lot of other people don't have as well," Mr Paterson says.