Priorities

June 20, 2019

Last month’s Budget was supposed to be focussed on wellbeing, but some of its priorities suggest otherwise:

Hon Amy Adams: Why, when Budget 2019 allocated $15.2 billion of new operating spending over four years, couldn’t he find enough funding in the Budget to ensure that Pharmac’s funding at least kept pace with inflation?

Hon GRANT ROBERTSON: As has been traversed in the House last week, Pharmac did receive an increase in funding. In this Budget, in the health area, based on the evidence, mental health received a massive injection of funding after being neglected for many, many years. The overall health budget has received a significant increase. On this side of the House—as I said in answer to the last question—we can’t make up for nine years of neglect in one year or even two years, but we’re making a good start.

Hon Amy Adams: How can he say that he’s used “evidence and expert advice to tell us where we could make the greatest difference to the well-being of New Zealanders”, when the Government has chosen to pour hundreds of millions of dollars into fees-free tertiary at the expense of giving Pharmac enough money to keep pace with inflation?

Hon GRANT ROBERTSON: The premise of that member’s question is incorrect. Money that supports education, money that supports health, and money that supports housing are all part of the Budget; one is not at the expense of the other. What we’re doing is actually making up for the enormous under-investment of the previous Government.

Money spent in one area is not at the expense of money that can’t be spent in another?

It can only be spent once.

Even if you look at different categories, you can question priorities.

Extra resources for children who get to school without the necessary pre-learning skills and for those at school and failing are only two areas of much greater need, and that would make a far greater contribution to wellbeing, than fee-free tertiary education for all students, whether or not they need that assistance.

Hon Amy Adams: How does he think the refusal to even keep Pharmac funding in line with population growth has affected the well-being of New Zealanders like 14-year-old Stella Beswick, two-year-old Otis Porter, or Bella Guybay’s four-year-old daughter, who are all waiting desperately for the funding of lifesaving medicines that are funded in almost every other OECD country?

Hon GRANT ROBERTSON: As the member well knows, and as with the time she was in Government, Pharmac make those decisions. We now spend nearly a billion dollars on the Pharmac budget, and we will continue to invest in that. But we will also continue to invest in the areas which the last Government completely ignored—such as mental health—because that is what New Zealanders asked us to do.

Hon Amy Adams: How does he respond, then, to Troy Elliott, whose wife is suffering from serious breast cancer, and has said that New Zealand’s medicines funding is starting to make us look like a Third World country and that “this Government has to wake up; we’re going backwards.”?

Hon GRANT ROBERTSON: I understand that for any family that is going through a situation where they have a family member with cancer, that is traumatic. What we know in this country is that Pharmac makes the decisions about what drugs it invests in. . . 

Pharmac makes the decisions but the government allocates the funds which determine how much, or little, it can do.

Health inflation is many times greater than general inflation and this year’s Budget funding for Pharmac isn’t even keeping up with general inflation.

 

 

 


Please sign the petitions

May 4, 2019

Eight health groups are combining to seek more funding for Pharmac to fund drugs that extend lives or improve their quality.

They’re urging people to sign their petitions:

A range of health groups are calling on members of the public to sign petitions that will presented to Parliament on 7 May. They call for medicines to be funded that will help New Zealanders live longer, healthier lives and reduce extreme suffering.

“We need kiwis to support other kiwis who often can’t stand up for themselves because they are too unwell,” Breast Cancer Aotearoa Coalition committee member Louise Malone says.

“This is a real opportunity for people to say to the Government that the time for proper funding of medicines is now.”

The groups will march to Parliament, starting at Wellington Library then to PHARMAC for a candle lighting ceremony in commemoration of those who have gone before. Once they reach Parliament, the petitions will be accepted by MPs.

The petitions call for dramatically improved medicines funding to provide the care that people with a range of serious illnesses need.

“The medicines are desperately needed,” Lung Foundation New Zealand CEO Philip Hope says.

“If everyone knew the suffering that people go through with these diseases, most wouldn’t hesitate to sign the petitions.”

The groups are Lung Foundation New Zealand, Breast Cancer Aotearoa Coalition, Ovarian Cancer New Zealand, Myeloma New Zealand, Pompe New Zealand and Chronic Lymphocytic Leukaemia Advocates New Zealand.

 

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Among the charities involved is Ovarian Cancer New Zealand.

Each year in New Zealand 350 women are diagnosed and 220 die from ovarian cancer. It’s the second biggest contributor to women’s cancer deaths from female specific cancers. Approximately one in 70 women will develop it in their lifetime.

New Zealand women with the disease don’t get access to the same drugs that are funded in other countries.

This is the motivation for a petition asking  Pharmac to fund Lynparza and Avastin for ovarian cancer, and also urging the Minister of Health to provide additional funding to Pharmac to enable the drugs to be subsidised.

Each year [in New Zealand] 350 women are diagnosed and 220 die from ovarian cancer. It’s the second biggest contributor to women’s cancer deaths from female specific cancers. In women with ovarian cancer linked to the BRCA gene, Lynparza can extend progression free survival by about one year and is reimbursed by Governments in Australia, UK, and most OECD countries. In women with advanced disease Avastin extends PFS by 6 months. . . 

Ovarian cancer is often diagnosed late because the symptoms aren’t recognised.

Every woman, and those who care about them, should familiarise themselves with the symptoms.

Potential symptoms of ovarian cancer include:

  • Bloating
  • Abdominal/back/pelvic pain
  • Eating less and feeling fuller
  • Needing to pee more often or urgently
  • Bowel changes
  • Fatigue
  • Indigestion
  • Abnormal vaginal bleeding
  • Painful intercause 
  • Unintentional weight loss

If women experience these for two weeks or longer they should tell their doctor. Ovarian cancer is detected with a blood test (CA-125) and ultrasound. 

The petition for better funding to treat ovarian cancer is here.

The other petitions are:

Breast cancer

Chronic lymphocytic leukemia

Lung cancer and Non small cell lung cancer

Myeloma

Multiple myeloma

Pompe disease

These organisations have recognised that insufficient money it the major reason Pharmac doesn’t fund treatments available in other countries which is why they’re asking that more is allocated.


NZ will win with TPP

October 14, 2013

Trade Minister Tim Groser said there was no need for concern about the content of the Trans Pacific Partnership:

“When this deal is done, I am certain that I and the Prime Minister will be able to come in from of New Zealanders and say: ‘this is virtually all upside’.”

“In relative terms, New Zealand will gain more than any country in TPP … the structure of these massive protective barriers that will come down will benefit New Zealand more than any country in this negotiation.” . . .

. . .  Mr Groser . . . said concerns about intellectual property and patents under the TPP had been “wildly exaggerated”.

He said the United States is the “most innovative country in the world” so their intellectual property law could hardly chill innovation.

New Zealanders would not be paying more for drugs as a result of TPP, Mr Groser said.

“I’ve said categorically Pharmac is not on the table.”

ANZCO Foods chair Sir Graeme Harrison said New Zealand has a lot more to gain from the TPP now Japan’s in the negotiations.

He said:

New Zealand could bring in $5 billion per year in our exports now Japan was involved in the Trans-Pacific Partnership (TPP), compared to $3.5 billion without Japan.

The increase in exports to Japan could mean a 2% gain in GDP, with many of the gains in the primary industries, he said. . .

He said Japan’s inclusion has made the TPP more worthwhile for the United States, which in turn will work in New Zealand’s favour.

“All of this comes together with two countries, the world’s first and third largest economy, both believing in a rules-based trading system, that are on our side, and we can have quite an influence in that process.”

Both were speaking on The Nation yesterday. You can watch the full interviews here.

New Zealand has a very small domestic market and we have one of the most open economies in the world.

We’ve already gone through the hard part of giving up protection and puts us ahead of most of the other countries which are negotiating the TPP.

We have a lot to gain and very little to lose from the successful completion of the TPP agreement.


Pharmac boss backs Herceptin decision

August 10, 2008

Pharmac chief Matthew Brougham explains the reasoning behind the decision to not fund 12 month courses of Herceptin.

He says that if one of his family had breast cancer he would recommend she take the nine week course which is publicly funded and that the jury is still out on the benefits of the year-long course.

The Herald editorial supports the decision and says that even if Pharmac had more money it would probably not spend it on longer courses of Herceptin.

And Kerre Woodham agrees that there is not enough evidence for Phramac to have reversed its decision to fund only nine weeks of the drug.

Update: Macdoctor responds to the Herald.


Herceptin, health & politics

August 8, 2008

Was Pharmac’s decision to not fund 12 month courses of herceptin based on clinical evidence or financial necessity?

Women’s Health Action Trust director Jo Fitzpatrick accepts it was clinical: 

[she] “reluctantly” spoke out yesterday in support of the decision, “because of concern at the high level of public misunderstanding about the drug and its effects”.

“Herceptin is promoted as the magic bullet for early breast cancer treatment,” she said. “People used to think – and many still do – that Her-2 positive breast cancer can and will be cured by Herceptin.

“We wish that was true but the evidence just isn’t there and people need to know that. At its best, 87 women in every 100 taking Herceptin get no benefit from the drug at all and may be harmed by it.”

And:

District health boards’ spokesman Murray Georgel said the lack of convincing evidence for 12-month treatments meant the decision was one “DHBs can understand”.

“In that context, and given the ability of DHBs to improve health through other interventions, it would have been concerning if Pharmac had come to DHBs and asked that the 12-month treatment be funded.”

But:

Other groups were scathing of the decision. Breast Cancer Aotearoa Coalition chairwoman Libby Burgess called it “a cruel blow for women and their families”.

She said the drug was “life-saving”, and Pharmac’s decision was “shameful” and “simply inhumane”.

Comments on my previous post  on the issue are also divided with Ed Snack saying it is important to judge the issue on science not emotion and he points to this link as a starting point. However Macdoctor  evaluates clinical trials and concludes Pharmac’s decision was a budget one.

But then NZ Conservative and several comments at No Minister  back Pharmac.

I am not qualified to argue about the science so I’ll move to the politics and this from TVNZ:

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”.

However over at the Hand Mirror Stargazer points out:

… national are saying they will fund the full 12 month course but legally would not be allowed to do so. unless, of course, they change the law to allow political interference in medical decisions.

She is right, Pharmac is independent and there are good reasons why neither the the Minsiter of Health nor the government can intervene. But that will be lost on most people because emotion beats facts in politics. Pharmac is regarded as an arm of government so unpopular decisions from the former will rebound on the latter.

Furthermore, Keeping Stock  points out the only other OECD countries not to fund 12 month courses of the drug are Turkey and Mexico.

As any parent will tell you “nearly everyone else does it” is not a convincing argument. But if most other OECD countries fund the treatment because they can afford to, even if the science is not settled; and we don’t because we can’t afford to then regardless of Pharmac’s independence we are justified in holding the government to account.


Why can’t we afford Herceptin?

August 7, 2008

Pharmac’s announcement it won’t fund 12 month courses of Herceptin for women with aggressive Her-2 breast cancer has been labelled a cruel blow by Breast Cancer Aotearoa Coalition chair, Libby Burgess.

Ms Burgess said it was “unbelieveable and shameful” that New Zealand women were denied the standard of care offered elsewhere.

“It’s a bad outcome, but we’re not terribly surprised by it. But we are of course extremely disappointed.

“This is a cruel blow for women and their families. Phamac’s continuing refusal to fund the treatments New Zealanders need is simply inhumane.”
 
Ms Burgess said that, to access the 12 month treatment their doctors were recommending, women had to fundraise the tens of thousands of dollars needed. 

“This adds huge stress and suffering for women when they most need support and comfort … I am amazed Government hasn’t stepped in to end this inhumane treatment of our women.

“Increased funding for medicines including Herceptin will surely become an election issue. That will give voters the opportunity to decide.

Pharmac chief executive Matthew Brougham said the cost wasn’t the reason the drug won’t be funded.

“I want to be absolutely clear; this decision is not about the cost of Herceptin. This decision rests solely on the science and our assessment, our confidence, around whether or not funding 12 months treatment with Herceptin would produce additional health benefits.”

But he also said:

[Pharmac]  had to consider all illnesses and treatments, not just cancer, and had to make a decision with limited funds about what would bring the greatest benefits.

“It’s not about who can scream the loudest and make the most noise.” Read the rest of this entry »


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