Pharmac seeks feedback on the funding of paediatric cancer medicines

Te Pātaka Whaioranga – Pharmac is seeking feedback on rule 8.1b of the Pharmaceutical Schedule – a unique exception that means any medicine currently used to treat cancer in a paediatric setting is automatically funded without a Pharmac assessment. 

“We are not committing to making any changes,” says Pharmac’s Chief Executive Sarah Fitt. “At this stage, we need to better understand the difference that rule 8.1b is making to the lives of children with cancer, their family and whānau, and the people who are working hard to treat and support them.” 

“All cancer treatments currently used to treat children will continue to be funded,” Ms Fitt assures. 

Rule 8.1b was set up when Pharmac took over funding decisions for cancer treatments from District Health Boards (now Te Whatu Ora) in 2005. 

“We’re revisiting the rule now because concerns have been raised around its fairness when compared with other populations and conditions, and the growth in costs of new cancer medicines,” says Ms Fitt. 

As it stands, rule 8.1b only applies to people treated in a paediatric setting. All adolescent and young adults with cancer and children with other illnesses or diseases do not have the same unrestricted funded access to medicines. 

“Evidence shows that health outcomes for children with cancer have improved drastically over the last few decades, but we don’t know how or to what extent rule 8.1b has contributed to this,” Ms Fitt says. 

“In 2020, about 93 percent of medicines used to treat cancer in a paediatric setting were already listed on the Pharmaceutical Schedule, so rule 8.1b is not used very often. However, the medicines funded through rule 8.1b accounted for about half the cost of all paediatric cancer treatments. 

“We have published a detailed document that explores the complex standard of care for children with cancer in Aotearoa and the effect rule 8.1b has, as well as a summary of the key points.” 

Consultation on rule 8.1b is open for six weeks from today (Wednesday 2 November).

Submissions can be made until 9am, Monday 27 March 2023 

“We know this is difficult to talk about, but it’s an important discussion to have,” says Ms Fitt. 

“We want to hear from a range of people and perspectives so we fully understand the management of paediatric cancer care and the impact rule 8.1b has. Feedback will help us understand if this funding approach needs to change.”