Cancer drug Keytruda free for eligible patients

The first of a slew of cancer drugs to be finally funded is officially available to patients from today, following Pharmac's multi-million dollar budget boost earlier this year.

Keytruda is now free for eligible patients with advanced triple-negative breast cancer, head and neck cancer, colorectal cancer, bladder cancer, and Hodgkin lymphoma.

A second drug, Opdivo, will be funded from 1 November for kidney cancer, while several other medicines are at various stages of public consultation or negotiation with drug companies.

Some clinicians had feared the sector would struggle to administer the extra drugs, due to lack of staffing and facilities in some regions.

But Cancer Control Agency chief executive Rami Rahai said he was confident the health system would be ready.

"We do have implementation funding to support the delivery of these medicines, which will help to recruit additional oncologists, nurses, pharmacists, and help support lab and radiology resources as well, to ensure that the system is empowered and supported to deliver on these."

The government has set aside $38m for "implementation funding" in the first year.

"It's not just about scaling up our current methods of care and delivery, we're also looking at alternative ways of delivering quality care closer to home for patients," Rahal said.

"It starts with those medicines that can be safely delivered outside large cancer centres, at smaller centres or even in primary care. We're talking about 'low toxicity' medicines, which don't have a lot of bad side effects.

"That's going to reduce pressure on cancer services."

The government announced the extra $604m over four years for the Combined Pharmaceuticals Budget in June, following widespread criticism of its failure to deliver on National's pre-election promises to fund extra cancer medicines.

The drug-funding agency's four-year budget is now $6.294 billion.

Patient Voice Aotearoa chair Malcolm Mulholland said it was "a great day" for all whanau affected by cancer, with thousands of patients were set to lead longer, healthier lives in the coming years.

"This is the largest single investment in new cancer medicines ever and it's going to make available many medicines that are badly needed by patients."

Some of the drugs would require fewer infusions than traditional chemotherapy, he said.

"So I would expect that in the longer term, you would actually free up more resources on the public health system."

A one-year course of Keytruda could cost up to $100,000, Mulholland said.

"So that's why we've seen patients resorting to Give-A-Little pages and the like.

"This is not the norm elsewhere in other countries, where they properly fund their procurement agencies."

It was particularly good news for women with advanced triple negative breast cancer, who had had few treatment options until now, and for patients with colorectal cancer, who had not had any new drug funded in 20 years, he said.

A small group of 20 to 30 patients have already been receiving Keytruda under an "early access" arrangement.

Cancer Society chief executive Nicola Coom said the new drugs rolling out from today represented "the largest of its kind in New Zealand".

"We are pleased that more than 1000 cancer patients will have access to new cancer treatments that they have otherwise had to self-fund.

"We acknowledge the health system is under pressure and there are workforce constraints, so we were pleased to hear Rami Rahal, CE Te Aho o Te Kahu Cancer Control Agency talk recently about a portion of this investment being directed to build capacity and support the system to deliver these new medicines."

Pharmac initially estimated the additional funding would cover approximately:

• 26 cancer medicines for a number of cancer types, including thyroid, bowel, breast, bladder, lung, head and neck, prostate, liver, ovarian, kidney and four different blood cancers. This includes treatments covering all of the cancer types covered by the list of 13 cancer treatments proposed previously plus other types not previously included (such as blood cancers).
• 28 other medicines that will include medicines for a wide range of conditions including infections, respiratory conditions, osteoporosis, sexual health, dermatology, inflammatory conditions, and mental health.

Up to seven of the 13 cancer treatments identified in 2023 will included, with the remaining six replaced by alternatives "as good or better".

At the time funding was announced, Pharmac said about 175,000 people would be eligible for treatment in in the first full year of funding of each medicine, although the exact number would depend on the specific medicines it decided to fund.