6. Rt Hon WINSTON PETERS (Leader—NZ First) Link to this
to the Minister of Health
Does he stand by his statement that the Pharmac board signed off on the decision to commit $3.2 million to the international clinical trial that is planned on Herceptin on 31 January 2007; if so, why?
Hon PETE HODGSON (Minister of Health) Link to this
I can say to the member that yes, I do, because it is true.
Rt Hon Winston Peters Link to this
If that is true, why then is Pharmac on record, on 7 March 2007, as saying that this money did not have Pharmac board approval; and why is Pharmac proposing to fund 9-week trials of Herceptin and Docetaxel, which is on the Pharmaceutical Schedule for New Zealand women with early-stage breast cancer, from June 2007, when the Ministry of Health’s Medsafe will approve such a treatment only if it is to be used for at least 12 months?
The answer to the first question is that the meeting of 7 March was between the chief executive of Pharmac and someone from the Breast Cancer Advocacy Coalition—I think that is its name—and the chief executive of Pharmac made a mistake. He then realised later that he had made a mistake, and on 19 March he phoned the spokesperson to correct the error. That is the case, and the phone message is documented.
Rt Hon Winston Peters Link to this
I raise a point of order, Madam Speaker. I was trying to clear up the first issue, but the real issue in that second question concerns why Pharmac is proposing to fund 9-week trials of Herceptin and Docetaxel, which is on the Pharmaceutical Schedule for New Zealand women with early-stage breast cancer, from June 2007, when the Ministry of Health’s Medsafe will approve such a treatment only if it is to be used for at least 12 months. I want an answer to that question.
Madam SPEAKERThat was not a point of order; it was in the form of a question. Is the member’s point of order that the Minister did not address the question? Well, it seemed to me that he did actually address that question, but the Minister may wish to address the supplementary question.
The process is still continuing. The district health boards are in a consultation phase to see whether they will proceed with 9-week treatments from 1 July. If they do, that may be in the form of a trial, or it may not. If it is to be in the form of a trial, it will be compared, one assumes, against 12-month treatments. The reason for that trial, if it is to proceed, is simply that although the 9-week research is significant—that is to say, the non-return rate of breast cancer is statistically significant—the trial is somewhat underpowered because the numbers were low. It was considered legitimate and reasonable for taxpayers’ money to take part in a larger trial to ensure that 9-weeks’ treatment is as significant as early indications would suggest.
Dr Jackie BlueHow was it that the chief executive of Pharmac made such a serious error when he clearly stated, on 7 March to a breast cancer group, that it was a “management and not a board decision”—a decision, which can only be described as radical, by Pharmac to fund, with $3.2 million of taxpayers’ money, an offshore Finnish trial in which no New Zealand women may ever participate—and why is it that this research was not flagged in its statement of intent?
I do not know how many of these questions, Madam Speaker, you would like me to answer, but just going with the statement of intent, I say that it refers to Pharmac’s statute. The statute of Pharmac expressly allows for research. How is it that this gentleman made what is called a serious mistake? I am not sure, but a few days later he found it out and corrected it. Is the research radical? Well, no, not if it is allowed for in statute.
Rt Hon Winston Peters Link to this
When did Pharmac conduct such a trial; and on what basis is Pharmac doing its pricing calculation, when in respect of Roche and Herceptin, and sanofi-aventis and Docetaxel, Pharmac has not even negotiated a price on these two drugs; in short, on what basis is he constructing his costings, and why is the New Zealand taxpayer funding an international multicentre trial?
We are participating, prospectively, in a trial; it is not yet clear to me whether it will go ahead. If it is to go ahead, it will have to be international to get the numbers. There are not enough people with that form of breast cancer in New Zealand for a trial to be carried out. As to the issue of costing, I say that it is fairly straightforward that if there is 9 weeks’ treatment versus 52, the cost will be about 20 percent of the original cost.
Rt Hon Winston Peters Link to this
I want to table the list of 22 countries—First World countries—that have Herceptin available on the basis of 12 months’ treatment, not some mythical 9-week treatment dreamt up by Pharmac.