This is the text extract for InPHARMation: May 2007, browse documents here.

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PHARMAC

Inpharmation

MAY 2007

From the Chief Executive

Herceptin funded for early breast cancer

The breast cancer drug Herceptin will be funded for women with HER2-positive early breast cancer from 1 July 2007. About 350 women are set to benefit each year from the decision by PHARMAC and District Health Boards. The decision represents an investment of $6 million per year by District Health Boards. A nine-week course of Herceptin, in combination with a taxane drug (such as docetaxel or paclitaxel), will be funded. The nine-week course, which has demonstrated efficacy in a clinical trial, represents the best value for money option for DHBs. In addition to the funding decision, PHARMAC will be developing resources for women with breast cancer and their families. Developing resources will help people understand more about HER2-positive breast cancer and the treatment options that are available, including Herceptin.

Making the Most of our Medicines

Work on a Medicines Strategy is underway and one of the key areas that is emerging is how well medicines are used once they have been dispensed to people. There is often a focus on New Zealanders gaining access to new medicines, however there is much to be gained from better using the medicines that are already available. How many people, for instance, take their medicines as instructed by their doctor? How much might people’s health improve if they did? There is also a growing trend for people seeking information on health – the rise of so-called “health literacy”. This area of optimal use – how to make sure best use is made of the $600 million of medicines that are currently funded – is in our view the single biggest challenge we face. For its part PHARMAC runs a number of campaigns that aim to ensure people use medicines as well as possible, and are well informed about them. To do this even better there needs to be a shift of focus from simply funding medicines to ensuring they are used optimally.

Matthew Brougham, Chief Executive (Acting)

This issue of inPharmation outlines some of those campaigns, including our long-running and successful Wise Use of Antibiotics campaign, and the new Gut Reaction campaign that is getting underway.

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One Heart Many Lives

Northland

One Heart Many Lives encourages people to take steps to reduce their chance of having a heart attack or stroke. The driving force behind extending the campaign into Northland is the sobering statistic that Maori men in Northland have the worst life expectancy of all New Zealanders. On average, Maori men in Northland live 14 years less than other NZ men. The campaign, which is being run in partnership with the Northland DHB and community agencies, aims to address this disparity through a range of community-driven initiatives. The campaign kicked off with a whanau day in Kaitaia on 22 April.

Tamati’s story

PHARMAC first encountered Tamati Davies in early 2006 when the One Heart Many Lives campaign was being developed in Hawke’s Bay. Tamati weighed in at 225kg before he was interviewed for a mini-documentary on heart disease and its impact on families. He had already had one heart scare (he was not yet 40) and was struggling to take his doctor’s advice to lose weight. Now, following the involvement of Hastings PHO Taiwhenua O Heretaunga, Tamati has become more active, eats better and has shed some 95kg since his health scare. He is now down to a relatively trim 130kg and wants to go lower, has completed a triathlon and is a spokesman for the impact of lifestyle changes.

Optimal use of medicines is emphasised in the campaign, which also encourages people to take control of their lives by eating better, becoming more active and stopping smoking. The campaign has run successfully in Porirua, South Auckland, the Bay of Plenty and in Hawke’s Bay. The Hawke’s Bay campaign already has a major success story in Tamati Davies, who has shed a massive 95kg since appearing in a minidocumentary to highlight the impact of heart disease on families.

Medicines and the patient experience - Practical Solutions

Building a culture of safety around medicines and reducing medication errors are two of the key themes for a two-day workshop in Wellington this month. The workshop, Medicines and the Patient Experience Practical Solutions, is a collaboration between PHARMAC, the Safe and Quality Use of Medicines Group, the Ministry of Health, ACC and BPAC. It involves government agencies, health professionals and consumers examining ways to ensure that safety considerations underpin patient care with medicines. The workshop includes speakers from NZ and internationally sharing perspectives on how to ensure medicines are used well. Optimal use of medicines is a key theme throughout the workshop.

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WISE USE OF ANTIBIOTICS PAIGN

CAM

Wise Use of Antibiotics is PHARMAC’s longestrunning public information campaign, and aims to encourage the optimal use of these important medicines. For 2007 the campaign is going `back to basics’ and emphasising the messages that have characterised the campaign for more than a decade: • Antibiotics don’t do colds or ‘flu

THE BUGS ARE CATCHING ON...

Remember the rules of engagement

IF in doubt check it out!

• If in doubt check it out; and for those who do require an antibiotic • Take the lot no matter what. The 2007 campaign is again being run in conjunction with pharmacists and Plunket and features new graphics and, for the first time, a TV commercial.

Get your flu vaccinations

The subsidised influenza vaccine season for 2007 is now underway. We anticipate increased demand as the `winter sniffles’ season emerges, and that the record number of doses distributed last year may be bettered. Doctors’ surgeries are now booking vaccinations so now is the time to give yourself the best available protection from influenza. PHARMAC has secured supplies from two vaccine manufacturers for 2007– Vaxigrip® from Sanofi Pasteur through Merck, Sharp & Dohme NZ and Fluvax® from CSL Pharmaceuticals. These vaccines have been formulated to provide immunity against three strains of influenza virus. The influenza vaccine composition for New Zealand in 2007 is: A(H1N1): an A/New Caledonia/20/99 (H1N1 -like strain (15 μg HA per dose) A(H3N2): an A/Wisconsin/67/2005 (H3N2) -like strain (15 μg HA per dose) B: a B/Malaysia/2506/2004-like strain (15 μg HA per dose)

Antibiotics don’t do colds and Flu! Take the lot, no matter what!

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More new medicines funded

PHARMAC’s programme of investing in new medicines is continuing with recent decisions including more funding for a medicine for Type 2 diabetes, and new medicines to treat HIV/AIDS. The number of people taking the Type 2 diabetes medicine pioglitazone (Actos) is set to nearly double after a decision to widen access. Pioglitazone, which makes people more sensitive to the insulin their body produces, is currently used by nearly 3000 people. The changes will mean the medicine can be prescribed by GPs as well as specialists. Other access changes include reducing the threshold in blood glucose measure (HbA1c levels), and reducing the body mass index measurement used to determine which patients are eligible. Approximately 100,000 New Zealanders are thought to have Type 2 diabetes and this number is growing by up to 10% each year. advantages over already-funded medicines and are important because the HIV virus can become resistant to existing treatments. Subsidising tenofovir and emtricitabine is an investment of approximately $1.5 million over five years. PHARMAC estimates that up to 159 people would be eligible for treatment with tenofovir and/or emtricitabine within three years. PHARMAC has been very active in extending the range of HIV medicines that are funded in recent months. Decisions have included funding for Kivexa (a combination treatment) Fuzeon (the first fusion inhibitor, a new class of anti-HIV drug) and Reyataz (a new type of protease inhibitor).

“Two new medicines to treat HIV were funded from 1 April 2007.”

Tenofovir (Viread) and emtricitabine (Emtriva) are comparatively new treatments that have similar actions to anti-HIV medicines that are already funded. However, they have some

This campaign is new for 2007 and aims to address high levels of prescribing for a type of medicine to treat gastro-intestinal disorders. Proton Pump Inhibitors (sold as Losec or Somac) are valuable medicines to have in treating gastro-intestinal disorders, peptic ulcers and dyspepsia. PPIs are generally regarded as safe and effective for long term and intermittent treatment. However, PPIs are expensive relative to some other medicines that do

much the same thing. They may be used unnecessarily to treat patients with only mild dyspepsia when older, less expensive and just as effective medicines may be just as suitable. Gut Reaction aims to encourage prescribing of PPIs only for those patients whose conditions merit them. Lifestyle changes, such as avoiding certain foods or reducing alcohol consumption, may be better ways for people to reduce those uncomfortable

feelings of heartburn. In others, simple over-the-counter heartburn treatments may work just as well. The first phase of the campaign is underway and involves pharmacists interviewing some of their patients who have been taking PPIs for six months or more. Information is also being prepared for doctors, practice nurses and consumers. You’ll hear more about this campaign as it continues over the coming months.

For more details check out

www.gutreaction.co.nz