Another Pharmac issue looms

A reader writes in:

Something you may be interested in, in light of your coverage of the controversy over funding pembrolizumab (Keytruda) in advanced melanoma.

Pembrolizumab has gained Medsafe approval as a first line treatment in advanced non small cell lung cancer:

http://m.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11841980

is currently considering a funding application, but there is of course no guarantee this will be successful. 

Would those who campaigned to bypass the normal processes last time around argue that the same thing should happen again? After all, advanced lung cancer has a very poor prognosis, with Maori and Pacific people having especially poor outcomes.

If not, how can favouring one group of patients over another be ethically justified, especially if doing so widens existing health disparities? (Melanoma is one of the very few cancer types where the incidence and fatality rate is much higher in non-Maori than in Maori).

Not only that, pembrolizumab being trialled for a LOT of indications. A quick search for “pembrolizumab” in ClinicalTrials.gov shows trials recruiting for breast, pancreatic, urological, gynocologic, and hepatic cancers among others, as well as myeloma and leukaemia. 

https://clinicaltrials.gov/

How many ‘exceptions’ can be made without blowing out PHARMAC’s budget? And did those who started down this road think about the unintended consequences?

All good points. Both National and Labour politicians should refrain from over-riding Pharmac decision making.

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