Pharmac consulting on two new medicines for lung cancer

Te Pātaka Whaioranga – Pharmac has reached provisional agreements with two different suppliers to fund two medicines to treat New Zealanders with advanced non-small cell lung cancer. The medicines are pembrolizumab (brand name Keytruda) and atezolizumab (brand name Tecentriq).  

“The medicines we are proposing to fund for advanced non-small cell lung cancer are types of immunotherapy called immune checkpoint inhibitors,” says Pharmac’s director of operations Lisa Williams. “Following our budget increase in May 2022 and our RFP seeking bids from suppliers in July, I am thrilled to announce today that we are seeking feedback on our proposal to fund pembrolizumab and atezolizumab.  

“Lung cancer is one of the most commonly diagnosed cancers in Aotearoa and it is the leading cause of cancer-related mortality, so Pharmac is very pleased to take this step towards funding immunotherapy treatments.”

Pembrolizumab

Pembrolizumab is supplied by Merck Sharp and Dohme and, if the proposal is approved, it would be funded by Pharmac for people with advanced non-small cell lung cancer, as first-line therapy, alone or in combination with chemotherapy, subject to eligibility criteria.

“We estimate that over 420 newly diagnosed people with advanced non-small cell lung cancer would receive treatment with pembrolizumab in the first year,” says Ms Williams. “This would increase to over 650 people per year after three years of funding.”

Merck Sharp & Dohme (New Zealand) Limited Director, Ms Vanessa Gascoigne, says, “I would like to congratulate Pharmac on its collaboration, stakeholder engagement and evidence-based decision making throughout this process. We are encouraged that Keytruda will potentially be available within New Zealand’s public health system from 1 April 2023."

Atezolizumab

Atezolizumab is supplied by Roche and, if the proposal is approved, it would be funded by Pharmac for people with advanced non-small cell lung cancer who have previously received chemotherapy.

“We estimate that in the first year, over 300 people with advanced non-small cell lung cancer who have received prior chemotherapy would receive treatment with atezolizumab,” says Ms Williams. “This would be expected to decrease to around 20 people after three years of funding as more and more people would receive treatment in the first-line setting with pembrolizumab.”

General Manager of Roche Products (New Zealand) Ltd Alex Muelhaupt says, “It's wonderful news that New Zealanders are now a step closer to accessing these immunotherapy treatments, including Tecentriq. Roche is committed to making an impact for patients and improving inequities in health outcomes, and our approach is to work in partnership with all areas of the health sector to help make this happen.”

Sector impact in funding these treatments

“We anticipate significant health benefits, in particular for Māori and Pacific people who are disproportionately affected by advanced lung cancer, would be achieved with the funding of immune checkpoint inhibitors,” says Ms Williams. “However, we know that funding these treatments would have a substantial service impact on our already stretched health system.

“Reducing barriers for those with advanced non-small cell lung cancer and their whānau, while minimising the impact for the health system as much as possible was an important consideration throughout this process. After releasing a Request for Proposals earlier in the year, we also began engaging with Te Aho o Te Kahu - Cancer Control Agency, and Te Whatu Ora to help to support resource planning for the health system to deliver lung cancer treatments.

Acting Chief Executive of Te Aho o Te Kahu, Nicola Hill, welcomed the decision. “As leaders for cancer control across Aotearoa, we are acutely aware of the benefit for patients and their whānau from public funding of these medicines, and also the need for them to be delivered in a way that improves equitable outcomes. We will continue to work with Pharmac and Te Whatu Ora to support services to safely administer these medicines to all eligible patients.”

The consultation is available on the Pharmac website for anyone wanting to have their say.

“Consultation is a very important step in our process,” says Ms Williams. “It’s how we check that the people who will get the most benefit from the medicines will be able to access them. If approved, we will continue to work closely with our colleagues across the health sector to plan for the implementation of both pembrolizumab and atezolizumab.

If approved, funding for pembrolizumab and atezolizumab would start 1 April 2023.