New cancer treatments
When PHARMAC receives a funding application, independent advice is sought from a team of expert doctors and pharmacologists. They consider the clinical evidence as presented in an application and provide advice to PHARMAC on the quality of the evidence.
Before a medicine can be marketed in New Zealand it must be registered with Medsafe(external link). For any medicine to receive public funding, it is an important part of PHARMAC's funding process to get further proof of the right dosage, who will benefit and who will be harmed.
Sometimes there is a desire to fund a new medicine before the clinical trials are completed, based on early results. PHARMAC is always open to new ideas about how to meet our objectives better. One of the ideas is the early access approach, which requires suppliers and PHARMAC to work closely together.
However, even evidence of the best quality requires careful consideration of its application to decision-making. A meta-analysis(external link) found that results of first trials that present large treatment effects often dissipate as new evidence accrues.
Overseas experience has shown that cancer medicines approved based on early signs of promise rarely deliver on that. In the US a study(external link) of 36 cancer drugs approved by the FDA between 2008 and 2012 on the basis of surrogate outcome measures, found that by 2014 only 5 were shown to improve overall survival. Analysis of European Medicines Agency approvals approvals for cancer drugs between 2009-13(external link) showed most entered the market without evidence of benefit or survival gain. More than three years afterwards, there was still no conclusive evidence that lives were extended or improved for most cancer indications, and when they did, these were often marginal.
New medicines are often presented as doing the job better than older medicines, and many come with an initial asking price that is often beyond PHARMAC’s reach. PHARMAC's role is to objectively review the evidence and make a decision that gets the best health outcomes.
There are a number of treatments being considered by PHARMAC for different types of cancers, including advanced melanoma.
Last updated: 10 May 2019