8. Rt Hon WINSTON PETERS (Leader—NZ First) Link to this
to the Minister of Health
Why, with respect to Herceptin, is the New Zealand taxpayer being asked to fund an international multi-centre trial when it is possible that not one New Zealand woman may take part, and on what basis did Pharmac administration get its recruitment rates of 600 patients?
Hon PETE HODGSON (Minister of Health) Link to this
In answer to the member’s first question—because if it were not an international multi-centre trial, it would not have enough horsepower to get a good result. In answer to the second question—that is the basis of early estimates only.
Rt Hon Winston Peters Link to this
If it is argued by Pharmac that this trial is to establish whether a 9-week trial is cost-effective and the best regimen, then how come the results of such a trial will not be known for another 5 years; and where is the efficacy or the ethics in this programme?
The member will be aware that the 9-week treatment has already been trialled and has already offered a statistically significant result. But the confidence intervals in such a result will be large because the trial was somewhat underpowered. In order to get a finer grade of the effectiveness of the 9-week treatment, a larger trial is being proposed. It is not yet clear whether it will proceed.
Dr Jackie BlueIf the 9-week multi-centre Herceptin trial fails to attract support from other countries and does not proceed, can the Minister confirm just what will be on offer to New Zealand women; if it is just the 9-week regime, does he agree with New Zealand biostatistician Associate Professor Chris Frampton in last week’s New Zealand Doctor magazine that the 9-week Herceptin regime is unproven and that Pharmac has been misrepresenting scientific evidence and claims about it?
I saw Dr Frampton’s remarks in the New Zealand Doctor and saw also a range of activities that Dr Frampton has had in the area. I simply say to the member that Pharmac has yet to make a decision on whether to proceed with offering women 9 weeks’ treatment—though I understand it is due to make such a decision later this month; I am not sure what that decision will be. In respect of the trial, if the trial does not proceed, it will not be through lack of effort from Pharmac and other interests in New Zealand to get it running. It might be due—
The member says other countries will not have a bar of it. She fails to acknowledge that in Finland, for example, where both 9-week and 12-month treatment is available, oncologists usually go for 9 weeks as a matter of choice.
Gerry Brownlee
Madam SPEAKERThe member was prefacing the question. Under the Standing Orders we tend to just want to ask the question without previous comment.
Rt Hon Winston Peters Link to this
“If I can ask the Minister” is hardly a preface. Let me start again. I ask the Minister, if that is true, why is it that in every other country this trial has been conducted Herceptin was funded for 12 months’ treatment, giving women entering the trial the choice of a standard treatment of 12 months or the trial, whereas New Zealand will be a country where women who enter the trial will not have an option of 12 months, so to get the proven treatment they will therefore be coerced into the 9-week trial; what sort of ethics is Pharmac now persisting with, and when will the Minister step in, given this thoroughly unethical choice that is being offered to women?
The Minister raises two good points. To the best of my knowledge there is no decision that, should there be a trial, New Zealand women would be offered only 9 weeks’ treatment. I am not aware of any such decision. On the other hand, the member raises the question as to why 12 months’ treatment was the treatment of choice across many trials. I think that is a very good question. I do not myself see any logic for 12 months’ treatment other than it being the time taken for the earth to move around the sun once. On the other hand, there is some logic for a 9-week treatment, because it is given with other forms of treatment, namely taxanes, and they are used for 9 weeks. It is thought that there may be synergy between the two.
Sue MoroneyHow is the breast-screening programme progressing, and in particular how many lives are being saved each year?
The breast-screening programme is progressing very well, and I am very grateful to those who are providing this good and growing service. The number of women covered has increased by 43 percent in the 2 years to June 2006, and I am advised that this service is now saving up to an additional 32 lives each year.
Heather RoyWhy will the Minister not listen to his fellow Minister the Rt Hon Winston Peters on this issue, and would he give Mr Peters’ views more consideration if he was sitting at the Cabinet table and fully involved in the decision?
Rt Hon Winston Peters Link to this
I raise a point of order, Madam Speaker. The views that I am expressing are the views of 23 First World countries; they are not my views. The second point is that the question is obviated by ACT’s failure to perform at the last election.
I pay careful attention to certain colleagues in this House, and one of them is the Rt Hon Winston Peters.
I seek leave to table a document in which Associate Professor Chris Frampton describes the 9-week course that Pharmac is proposing as “unproven”.