Cancer patients, advocates 'gobsmacked' Pharmac declining funding application for life-changing drug

Ovarian cancer patients and advocates are "utterly gobsmacked" Pharmac has proposed to decline a funding application for a life-changing drug.

Tauranga-based mother and teacher Margaret Waaka was 62-years-old when she was diagnosed with stage four high-grade serous ovarian cancer.

After trying different treatment options, she was advised to give unfunded treatment Avastin (Bevacizumab) a go.

She is now on three-weekly treatments - costing around $36,000 a year to stay alive.

"So far I have had 22 treatments. When I stop taking it, I will be looking at only months to live," she said.

An application was lodged with Pharmac to fund Avastin in 2013, but the drug-funding agency has since put out a proposal to decline 97 applications, including the ovarian cancer drug.

Pharmac is currently calling for submissions on the proposal, with consultation closing on Friday, July 30th.

Waaka said she was "utterly gobsmacked" to learn that Pharmac is considering taking Avastin off the waiting list.

"How can they have this attitude to women's health?" she questioned.

"Avastin is funded by other countries including our neighbours across the ditch and it offers hope and increased life expectancy for those of us who live with this unexpected terminal illness. 

"Ovarian cancer is the fifth killer of women. It affects a huge number of women but has a very low profile and generally, women with the disease don't live long enough to fight for themselves.

"Pharmac absolutely cannot just quietly slide this funding application off the list. That is unbelievably unfair to women."

The sentiment was shared by Cure Our Ovarian Cancer NZ and Talk Peach Gynaecological Cancer Foundation, who have made a joint submission to Pharmac expressing their opposition on behalf of Kiwi women with the cancer. 

"We have a two-tiered system where those who can pay live longer than those who can't. The reality is Australians with ovarian cancer have more funded treatments and that's one of the reasons they live longer than New Zealanders," says Jane Ludemann, the founder of Cure Our Ovarian Cancer NZ.

Ludemann said during Pharmac's initial look at their application, the committee considered that dense dose chemotherapy could deliver the same or better results than Avastin. But she said a clinical trial showed it does not provide any additional benefits to people with ovarian cancer. 

Another factor in Pharmac's decision to deny funding was the cost of the drug, but Ludemann said with the advent of bevacizumab biosimilars, Pharmac is now in a strong position to negotiate on cost. 

Pharmac's director of operations Lisa Williams told Newshub they have an application for the drug and sought clinical advice from its Pharmacology and Therapeutics Advisory Committee (PTAC) and the Cancer Treatments Subcommittee on this application.

"It was recommended for decline," she said.

"Our clinical experts recommend some medicines for decline because there are other funded medicines for the same condition, the medicine would provide no additional benefits over other treatments we already fund, and/or the medicine may be harmful."

She told Newshub for bevacizumab, their advisors decided that the quality of the evidence, along with its high cost and the unapproved dosing regimen proposed by the supplier made it difficult to recommend for funding.  

Williams said the proposed consultation process is a way for health professionals, patient groups and suppliers to give feedback and provide any new information about the medicine.

She said there will always be more medicines than they are able to fund.

"This means we need to make some difficult choices and we will always have medicines that we'd want to fund if we had more money available," she said.

"New cancer medicines are constantly being developed, and we understand and can appreciate that New Zealand consumers, clinicians and patient advocacy groups have high expectations about having timely access to new medicines for cancer conditions. New cancer medicines often come with a significant cost and limited evidence of effectiveness, which can make it challenging for Pharmac to make robust, evidence-based decisions."