Oncologist’s plea: National’s broken cancer drug promise harms all patients

The 13 cancer drugs paraded by National before the election were never intended to be a definitive guide, writes oncologist professor Christopher Jackson who co-authored a 2021 report to highlight the gap in available cancer drugs between NZ and other countries.

Inform your opinion: There are few of us lucky enough to walk through life unaffected by cancer. Whether it be a parent, a spouse, a friend, a workmate, or even ourselves, cancer has touched us all.

Most of us know someone with an incurable cancer who has learned that there might be a drug that could keep them alive longer but isn’t publicly funded. A drug that could keep them alive for another anniversary, another birthday. To get to a family wedding, to see a child go to school or to be born. Cancer drugs represent hope; hope that we might get a little bit more time to do those things that matter most in life. Just one more day.

Pharmac has often been painted as the villain in this situation, as the gatekeeper that decides who gets funded drugs and who does not, like some dystopian pharmaceutical version of The Hunger Games. Its black box and notoriously opaque processes leave patients, advocates and doctors frequently flummoxed by funding decisions. Patients have few avenues other than media pressure or Givealittle pages to access the drug that gives them that once last chance, that one last hope.

Behind the scenes, pharmaceutical companies charge increasingly exorbitant prices for cancer drugs whose cost seldom bears relationship to their benefit. Some newer agents are priced at more than $50,000 a month. At that price, you’d expect to buy an outcome like Lazarus, yet the data often shows the majority who take them derive no benefit at all, except for perhaps hope.

There have been very few occasions where politicians have played as directly on this hope as occurred in the lead-up to the 2023 election. National announced it would fund 13 specific cancer medicines, ostensibly not picking winners because “the Cancer Agency chose them”, not the politicians - all they did was offer hope.

That was until the Budget. There was money for pothole repair and landlord tax exemptions but nothing for those seeking respite from cancer as promised in year one of a National-led government.

Suddenly, it was too hard, there was work to be done, and the solutions were to be worked through with a curiously indefinite time frame. National already knew these problems – it faced them when it promised to fund Herceptin in the 2008 election campaign and had to deliver outside Pharmac once it became government.

There are two distinct questions when it comes to public drug availability. The first is how much to spend. That’s a matter of budget and therefore relative priorities for government funds. The second is how to best spend the allocated money, and it’s where politicians have largely stayed out.