Blow for breast cancer patients 

Breast cancer patients are outraged over Pharmac's latest refusal to fund a year long course of the drug Herceptin.

Pharmac currently funds treatment with Herceptin for early stage HER-2 breast cancer for nine weeks and has been rejecting calls from clinicians and women's health groups to fund it for 12 months.

Eight breast cancer patients had raised their own money to take Pharmac to court in February and all eight paid for their 12 month Herceptin treatment.

The court ruled Pharmac had to go back and reconsider its decision not to fund the year-long course.

But the drug-buying agency argues there is no evidence to extend the treatment beyond the current nine week regime. Chief executive Matthew Brougham says Pharmac believes it is "the most responsible decision that a reasonable and fair public agent could make".

Pharmac says money is not behind its decision to decline the longer programme. Brougham says it would be irresponsible of the publicly-funded company to spend any extra money on the drug and it would have been unfair to other patients to subside 12 months of it.

He says the $15 million could be better spent on other treatments which could provide health benefits. He says he understands the move will be upsetting for many people, but he is confident it is the right decision.

But the decision is a blow to many who argue that 33 other countries fund it for 12 months so why can't New Zealand.

Herceptin Heroines spokeswoman Chris Walsh says she feels really frustrated and the decision is distressing and puzzling. She says 33 other countries fund the 12 month course, proving the clinical evidence is there.

"I just can't understand their rationale. The same old rubbish is coming out from Pharmac and it's tedious," says Dr Walsh.

The decision is a blow to Her-2 breast cancer patients like Melissa Murphy.

"Having cancer and going through all this is stressful enough," Murphy says.

The Auckland mother of four has just finished her nine weeks of free Herceptin and the only way she can get more is to rely on charity. Murphy's local church is trying to raise the $55,000 she needs.

"I've got four young children to think of so I need to do what I can to give me a longer survival rate."

Her husband Stuart says they have never needed to rely on the government for benefits or anything and now when they are in need of help "the money's not there to help us".

The Herceptin fight has been controversial, involving three petitions to parliament. A judicial review brought by eight cancer patients forced Pharmac's latest re-think.

"The nine week trial...is a robust, sound study," Pharmac says.

Brougham says Pharmac will review its decision if any new information comes to light.

Pharmac's decision is being supported by the Women's Health Action Trust which calls the ruling brave and difficuIt. Director Jo Fitzpatrick says her organisation entered the Herceptin debate because of concern at the high level of public misunderstanding about the drug and its effects.

She says Herceptin is wrongly promoted as the magic bullet that can and will cure HER2 positive breast cancer. "We wish that was true but the evidence just isn't there and people need to know that," says Fitzpatrick.

"Common practice is not best practice.

"The nine week course offers the best balance between potential benefits and harms for Herceptin. In choosing the nine week course of Herceptin treatment, Pharmac has made a considered and careful decision."

But other lobby groups say the Pharmac decision means Herceptin will now become an election issue.

The National Party says that if it is elected it will fund the 12 month course. MP Jackie Blue says the issue is very important and "we just want to do the right thing". And National's health spokesman Tony Ryall says the government has got its spending priorities wrong if it will spend millions on health bureaucrats but nothing so women can get Herceptin.

However Health Minister David Cunliffe has hit back hard. He says Ryall is advocating in favour of ad hoc decisions that would defeat the evidence-based processes used by Pharmac.

Diane Edwards from Herceptin Heroines says "there's not a woman in this country that can afford to vote for this government after today's decision".

And they say their fight is not over yet.

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