Last month Pharmac made a decision to continue funding the full and effective nine-week course and not fund a 12-month treatment.
There has been much comment about the decision, and I want to assure people that it was made carefully.
It is unfortunate that herceptin continues to be labelled a “wonder drug” and one particular 12-month treatment as the “gold standard”.
These claims are misleading and do a disservice to women and their families contemplating their treatment options.
We started our evaluations from square one and took a comprehensive approach, seeking fresh clinical advice, re-evaluating the evidence, looking again at cost-effectiveness, and considering people’s views.
It is clear that there are still question marks over whether the longer treatment works any better than the full and effective concurrent nine-week course that is fully funded.
We don’t have confidence that taking the drug for longer would show better results.
Without that confidence, and considering concerns about the potential side-effects of the 12-month treatment, it would not be responsible to fund the longer treatment. Some people say the evidence is stronger for 12 months.
If the evidence was compelling then there would be no basis for the approval given by ethics committees for the clinical trial comparing the nine-week and 12- month treatments.
That trial, called Sold, is designed to determine the best use of herceptin and is recognised as addressing an important question.
Others say a 12-month treatment is not being funded because of its cost. It does cost a lot of money ($ 25 million per year in total), but that was not a factor in this decision.
The reason was simply that we are not convinced that there are extra benefits from the longer treatment
The decision on herceptin was difficult given the high public interest and extensive advocacy for a 12-month treatment. We remain open to re-evaluating the funding of herceptin if new information emerges. MATTHEW BROUGHAM Chief executive, Pharmac