Call for better medicine deal

New Zealanders deserve improved access to new medicines and vaccines when they need them, argues Dr Graeme Jarvis.

TODAY is world cancer day; the theme for 2015 is Not Beyond Us. I believe there is still a long way to go when you benchmark New Zealand against other countries, most notably our neighbour, Australia.

A recent study published in the New Zealand Medical Journal of 2000-07 data showed that, at one year, New Zealanders’ survival gap was more than 10 per cent lower for lung cancer, 14.7 per cent lower for female liver cancer and 11.6 per cent lower for ovarian cancer.

Most cancers showed the same pattern – survival in New Zealand is significantly lower than in Australia at one year and the difference persists at five and 10 years regardless of the type of cancer.

The New Zealand Medical Journal study showed breast cancer survival differences increased with time, being 1, 3 and 4 per cent lower in New Zealand than Australia at one, five and 10 years respectively.

This suggests that early diagnosis, including mammographic screening, may be comparable but there may be differences in further treatment. Reductions in breast cancer mortality in Australia have been shown to be linked with the increased use of adjuvant hormonal and chemotherapy.

The UK Office of Health Economics cites the Richards Report which undertook an international comparison of medicines usage in 14 countries – New Zealand, Australia, France, Germany, Italy, Spain, UK, Austria, Denmark, Norway, Sweden, Switzerland, Canada and the United States.

The report revealed that New Zealand came last in terms of usage of cancer medicines licensed within the past five years and last for cancer medicines licensed in the past 6-10 years.

New Zealand ranked last in both 2009 and in 2013 in both categories.

Another study focused on the inclusion of cancer drugs under the publicly funded system in 13 countries – New Zealand, Australia, Canada, England, Finland, France, Italy, Germany, Japan, the Netherlands, Scotland, Sweden and the US.

The study looked at how many licensed medicines were then publicly funded. New Zealand came in last at 25 per cent.

New Zealand is the only OECD country with a capped pharmaceutical budget and while Pharmac does its best within the existing budget, the trade-off is reduced access to new medicines. This means that medical conditions are not treated optimally with the most effective treatments.

No wonder New Zealand ranked last for inclusion of cancer drugs in the publicly funded system.

The Government’s introduction of Faster Cancer Treatment Indicators suggests that delay in the time from referral to treatment has been a problem.

While as an industry we applaud faster access to specialists and treatment New Zealand’s use of old medicines cannot be ignored.

We have to ask the question – faster access to what?

Australia correlates increased breast cancer survival with the use of new therapies and arguably this would be the same for New Zealanders, across a range of cancers.

In New Zealand, patients may be getting diagnosed quicker, but in some cases they are being given treatments which are 40 years old.

Providing New Zealanders timely access to innovative treatments that can increase cancer survival should and can be something which is – Not Beyond Us.

New Zealand is the only OECD country with a capped pharmaceutical budget and while Pharmac does its best within the existing budget, the trade-off is reduced access to new medicines.

Dr Graeme Jarvis is the general manager of Medicines New Zealand, the industry association representing companies engaged in the research development, manufacture and marketing of prescription medicines and vaccines.