16 Dec 2022

Pharmac set to fund two sought-after lung cancer drugs, Keytruda and Tecentriq

11:33 am on 16 December 2022
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Keytruda funding has long been pushed for by campaigners. Photo: Supplied

Lung cancer patients could soon have access to two new drugs which could double survival rates for some people with the disease.

Pharmac has reached provisional agreements with the markers of Keytruda and Tecentriq, following an increase to its budget in May, and is now seeking feedback.

"We had a really significant budget increase in May this year - $71 million for this year and $120m for next year - so we're making good use of that money and investing it in a lot of new medicines," Pharmac director of operations Lisa Williams told Morning Report on Friday.

Lung cancer kills about 1800 New Zealanders a year.

Oncologists say the drugs work best in people with advanced cancer, and will particularly benefit Māori and Pasifika, who suffer disproportionately from the disease.

Keytruda is the brand name for pembrolizumab, manufactured by Merck Sharp and Dohme. It's a first-line treatment, used either on its own or in combination with chemotherapy. Within a few years of funding starting, it's expected more than 650 people a year will qualify for Keytruda.

Tecentriq, known to scientists as atezolizumab, is made by Roche. It's only used if first-line treatments and chemotherapy fail to do the job. More than 300 people a year are expected to qualify.

"This is another example of how the government's boost to the medicines budget is helping New Zealanders," Health Minister Andrew Little said in a statement, pointing out just which medicines get funded is out of politicians' hands.

Pharmac first considered funding Keytruda as far back as 2015, as a melanoma treatment, but said at the time there wasn't enough evidence to suggest it worked. It later changed its mind, funding Keytruda for treatment of melanoma in late 2016.

Pharmac was again looking to fund Keytruda for lung cancer patients in 2020, but pulled out, citing rising costs of other medicines due to the arrival of Covid-19.

Under Pharmac's proposal, there will be nine criteria patients will need to meet to qualify for either treatment.

"The main key thing being that the person has locally advanced or metastatic unresectable non-small cell lung cancer, because there's two different types of lung cancer and these products only work for the non-small lung cancer.

"And where they are in their treatment pathways - have they already had chemotherapy or not? If they've already had chemotherapy they can have Tecentriq; if they haven't had chemotherapy, they can have Keytruda."

If approved, funding for the two treatments will start on 1 April. But despite a years-long push to get better cancer drugs - particularly Keytruda - there's one more hurdle to jump. Pharmac is seeking feedback from the public and healthcare sectors just to make sure they've got the right drugs and set fair eligibility criteria.

"People can come back and tell us that they think we've got it wrong," Williams said.

"We've had that happen in the past. It's not very common, but we've had it where we go out with a particular treatment for a particular disease, and people come back and say, 'We don't actually want that one - we want something else'."

Williams said Pharmac is also aware the health system is already stretched.

"[They are] delivered by intravenous injection in hospital - so that means more people sitting in chairs, nurses to help them with that, and doctors' appointments and impact on hospital pharmacy services.

"We've costed all of that out and we've been working really closely with Te Aho o Te Kahu (Cancer Control Agency) and Te Whatu Ora to help them to do their resource planning so they're ready to deliver this."

Consultation is open until 24 January, and Pharmac's decision-makers will make a final call in February.

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