Nine unfunded blood cancer drugs could boost survival and quality of life

Blood cancer patients in Australia have access to 36 treatment options not funded in New Zealand - of which nine significantly improve survival rates and quality of life, according to a report.

The Cancer Control Agency, which produced the 126-page report, said it was the first time it been able to assess the "magnitude" of blood cancer medicines' clinical benefit.

Its chief executive, Rami Rahal, said there had been "concern" for several years that New Zealand was lagging behind in Australia in terms of access to blood cancer medicines.

A 2022 report - Understanding the Gap: an analysis of the availability of cancer medicines in Aotearoa - had revealed the extent of medication gaps and the "potential" impact on patients.

At the time, the agency committed to assessing the magnitude of clinical benefit for blood cancer medicines as soon as the "relevant tool" became available.

"We are very pleased to now deliver on that commitment and complete this work with the release of Understanding Blood Cancer Medicine Availability in Aotearoa New Zealand," Rahal said.

"While a number of medicines available in New Zealand are also available in Australia, the report shows there are some gaps.

"We now understand what those gaps are, how many there are and what these gaps might mean for patients."

The situation improved earlier this year with Pharmac's decision to fund medicines for six types of blood cancer, but that left a shortfall of 36 treatment options, Rahal said.

Of the nine showing "substantial magnitude of clinical benefit", Pharmac was considering funding six of them.

There were no current applications for the other three.

However, the analysis should not be treated as a shopping list for Pharmac, Rahal stressed.

It was the "exclusive domain" of Pharmac to decide which medicines to fund based on consideration of a wide number of factors.

"The funding of cancer medications is complex, and this report is not a list of medications that should necessarily be prioritised for funding by Pharmac. Medicine funding should also be considered in the wider context of cancer control.

"Medicines play an important part, but we must also continue to think about ways to strengthen prevention measures, improve early diagnosis, encourage participation in screening programmes and ensure high-quality care is available to all."

Leukaemia and Blood Cancer New Zealand chief executive Tim Edmonds said the onus was on the government to act on the findings and ensure blood cancer patients were not "left behind".

Before the election, the Health minister Shane Reti assured blood cancer patients they would "not be forgotten" when the report was received.

"We call on the government to deliver on their promises to blood cancer patients, and to act swiftly to fund the six medicines that have been identified by the Cancer Control Agency and sit with Pharmac awaiting funding," he said.

"If we fail to act, the government is sending a devastating message that closing gaps in priority cancer medicines access is happening with blood cancer patients excluded."

This gap echoed the findings of the 2022 report, which focused on solid tumour cancer and identified medicines that would offer significant clinical benefit to New Zealander if funded.

That report triggered the pre-election promise by the National Party to fund 13 cancer medicines, and the $604 million uplift to Pharmac's budget.

More than 21,000 New Zealanders are living with blood cancer, which is the third leading cause of cancer-related death in this country.

Every year, in Aotearoa, about 2800 people are diagnosed with a blood cancer.

There are no known prevention or screening interventions for blood cancers. Cancer medicines (along with stem cell transplant) are the major treatment options.

The analysis showed that:

• On 1 January 2024, 24 individual blood cancer medicines were available in Australia, but not New Zealand, for 42 different cancer treatment indications (or uses).
• Twelve of these demonstrated a high degree of improvement in quality of life and/or survival.
• Two of the 12 can cure blood cancer, with the rest used to manage symptoms.
• Since then, Pharmac has funded four blood cancer medicines for six different uses that were identified as gaps in the report.
• This reduces the number of current medicine-indication gaps between Australia and Aotearoa to 36, nine of which have substantial magnitude of clinical benefit. Three are for the treatment of acute lymphoblastic leukaemia, three for acute myeloid leukaemia, and one each is for mantle cell lymphoma, chronic myeloid leukaemia and chronic lymphocytic leukaemia.
• Of the nine-remaining gaps with "substantial magnitude of clinical benefit", Pharmac is considering funding six of them.
• There were 13 blood cancer medicines publicly funded in New Zealand that were not funded in Australia.

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