Pharmac proposes to fund treatments for breast and blood cancer

Pharmac – Te Pātaka Whaioranga is seeking feedback on a proposal to fund two new treatments for advanced breast cancer and a type of blood cancer. The treatments, ribociclib (branded as Kisqali) and midostaurin (branded as Rydapt), are part of a bundle deal with the supplier, Novartis.

“We’re really pleased we’re in a position to look at funding two more cancer treatments,” says Pharmac’s director pharmaceuticals, Geraldine MacGibbon. “Both treatments are targeted cancer therapies, helping to slow down the progression of the disease, giving people more time to spend with their whānau.”

Ribociclib for a type of advanced breast cancer

Pharmac is proposing to fund ribociclib (branded as Kisqali) for people with HR-positive, HER2-negative locally advanced or metastatic breast cancer. Ribociclib is a targeted cancer therapy called a CDK4/6 inhibitor, which blocks the development of cancer cells.

In 2020 Pharmac funded another CDK4/6 inhibitor called palbociclib (brand name Ibrance), approximately 400 people started on this treatment in 2022.

“We’ve heard from our clinical advisors that having another treatment option would be beneficial for people with this type of advanced breast cancer. They’ve told us that ribociclib may provide greater health benefit for those eligible for treatment,” says MacGibbon.

As part of the consultation Pharmac would like to better understand how many people would be likely to start treatment with ribociclib compared to palbociclib.

“We know that Māori and Pacific women experience breast cancer at a higher rate and at a younger age than non-Māori and non-Pacific. We understand that 17% of those taking palbociclib currently are Māori. We hope by funding ribociclib we are able to help improve the health outcomes for these communities.”

Midostaurin for leukaemia

Pharmac is proposing to fund midostaurin (branded as Rydapt), for people with a type of blood cancer called acute myeloid leukaemia (AML) with a specific gene mutation known as a FLT3 mutation. AML reduces the body’s ability to produce healthy blood cells, and the targeted therapy, midostaurin, counteracts this. 

“We understand one-third of people with AML have a FLT3 mutation are experiencing negative health outcomes, so we hope by having this treatment available people will be able to maintain health and be less likely to experience progression of their disease.”

Funding treatments through negotiation

As part of the deal with Novartis, the net price of another treatment – sacubitril with valsartan (branded as Entresto), which is already funded – would reduce via a confidential rebate.

“Both ribociclib and midostaurin have been recommended for funding with a high priority by our clinical advisors. Negotiating with suppliers for new treatments and looking at what we already fund from them helps us to make more medicines available.”

“Consultation is a really important part of our funding process. It’s how we ensure that we are making the best decisions for New Zealanders and that the treatments will fit the needs of the community,” concludes MacGibbon.

If the consultation is approved, both treatments would be available from 1 July 2024.

Consultation closes at 5pm, 10 January 2024 and feedback can be emailed to consult@pharmac.govt.nz