Medical oncologists and nurse practitioners who treat gastrointestinal cancers continue to be frustrated by the increasing gap between what is available and funded for New Zealand patients with gastrointestinal cancers and what is available in similar jurisdictions – for example Australia’s PBS or UK’s NICE. This is now impacting on New Zealand patients’ ability to access clinical trials as the standard of care arm is frequently now not funded in GI cancers. We are barely keeping pace with the WHO’s essential medicine list.
We hold out hope for opportunities for increasing access via biosimilar cost savings.
This disparity presents challenges to patients and their whanau as self-funding at “retail” is out of the reach of most except the wealthiest including, as it must, by Ministry of Health edict, the administration costs in a private day unit also. This serves to further exacerbate the inequity in outcomes between underserved populations and the privileged.
The subsequent moral injury experienced by involved clinicians cannot be underestimated. Knowing that patients are no longer receiving cancer care as per international guidelines and being powerless to effect change is increasingly common. Please do not accept our silence as compliance.
One can understand the frustration of medical specialists working in a healthcare system which “exacerbates the inequity in outcomes between underserved populations and the privileged” when it comes to availability of cancer drugs but in attacking Pharmac they are attacking the messenger rather than the two root causes of the problem which are:
- The outrageous pharmaceutical company charges for these modern drugs (or for older drugs for that matter!) All of us will accept that new leading-edge drugs are costly to develop with long-lead-in times before they become available but when drug companies are still spending more on advertising drugs than on research and development we know we have a serious moral and ethical crisis at the heart of the pharmaceutical industry.
- The failure of successive New Zealand governments to tax the unearned incomes of the wealthy. Wealthy New Zealanders spend less that half the proportion of their income in tax than those on the lowest incomes. If they were taxed at the same rate as workers there would be plenty of money for the whole range of treatments available through modern drugs – not to mention the desperate needs for funding right across our public services.
By focusing on Pharmac the oncologists are doing the drug companies’ promotions for them. Likewise election campaign promises from political parties for more funding for Pharmac are a short-term fix which again does nothing the address the root causes of the problem.
Without big increases in drug funding each year “…we’ll just keep falling behind in the way that we are at the moment” says Gut Cancer Foundation executive officer Liam Willis.
A chilling view comes from ACT candidate Todd Stephenson who has called for Pharmac to take a “productivity focus” to decisions on who gets funded medicine. Stephenson is No 4 on the Act Party list and has recently returned to New Zealand after more than a decade working in the pharmaceutical industry in Australia.
“A lot of the treatments and the innovations being brought forward can actually deliver economic benefits because you’re treating people who can work longer or go back to work when that wasn’t possible.”
“It would be good to be able to take a more holistic approach to what these treatments are bringing.”
When asked if that meant more economically productive people should be prioritised for treatment, Stephenson said: “Not necessarily, but when you’re looking at the value of these treatments, that should be taken into consideration.”
How Orwellian is that? Reading between the lines here means prioritising “productive” people for drug treatments ahead of the retired, beneficiaries and low-wage workers.
It’s not hard to see where this policy leads…