Funding nivolumab in combination with ipilimumab for eligible people with kidney cancer
We expect about 110 people with metastatic kidney cancer would benefit in the first year of funding.
Both nivolumab and ipilimumab are immune checkpoint inhibitors. They work by helping the body’s immune system to fight cancer cells. The medicines are given to people in hospital. People would start on both medicines, then after a few cycles with ipilimumab, would continue on nivolumab only until the cancer gets worse or the treatment cannot be continued for other clinical reasons, like toxicity.
From 1 November, we funded nivolumab for kidney cancer as a second treatment, however we are now proposing it for funding as a first treatment option. People would be able to access other medicines like lenvatinib with everolimus, or axitinib or sunitinib (both included in these consultations) at other points in their treatment if approved.
Widening access criteria to sunitinib for eligible people with kidney cancer
Sunitinib is currently funded for people with kidney cancer who have an intermediate or poor prognosis. After its inclusion in the 2023/24 Annual Tender, in July 2024 we consulted on widening access for people with kidney cancer who have a good prognosis, and now we are considering widening access further so it can be used at any point of treatment for more people. We are proposing this because of the changes made and proposed for the treatment options for kidney cancer.
Sunitinib is a type of medicine called a tyrosine kinase inhibitor. Tyrosine kinase inhibitors impact the metabolic processes involved with the development of cancer. They slow down the progression of some cancers and may help people live longer.
Funding axitinib for eligible people with kidney cancer
We expect about 10 people with metastatic kidney cancer who have progressed after using a different treatment would benefit in the first year of funding. However, this estimate would change if the proposal to fund nivolumab in combination with ipilimumab is approved.
Axitinib is an oral tablet taken daily to stop the growth and spread of cancer cells.
Funding inotuzumab ozogamicin for eligible people with acute lymphoblastic leukaemia
We expect about 15 people would benefit in the first year of funding.
B-cell acute lymphoblastic leukaemia/lymphoma (ALL) is an aggressive form of ALL where there are too many white blood cells in the bone marrow and blood, which means the cancer is able to spread easily to other organs.
Inotuzumab ozogamicin would be funded for people with B-cell ALL that has come back after, or has not responded to, initial treatment. This includes people with only a small amount of cancer left after initial treatment. Inotuzumab ozogamicin would be funded for all eligible people regardless of their transplant status.
Inotuzumab ozogamicin is a targeted cancer medicine given in hospital. It is a combination medicine made up of inotuzumab, which identifies which cells to destroy, and ozogamicin, which then destroys the cancer cells to prevent the cancer developing further.
Funding crizotinib for eligible people with non-small cell lung cancer
We expect about 20 people would benefit in the first year of funding.
Crizotinib would be funded for people with the most common type of lung cancer, called non-small cell lung cancer, who have a mutation in their ROS-1 gene. It would provide substantial benefit for this group of people compared to currently available treatment options.
It is an oral capsule that is taken daily to stop the growth of cancer cells. It would provide a targeted treatment option for people to take at home, compared to current treatment with chemotherapy in hospital.
We fund immune checkpoint inhibitors (pembrolizumab and atezolizumab) for this group of people, but have received advice these medicines have limited effectiveness for people with this mutation. As we are proposing to fund crizotinib for people with ROS1 mutations, we are proposing to remove access to pembrolizumab and atezolizumab for this group when the contract at the end of the Principal Supply Status period in 2026.
Funding ceftazidime with avibactam for eligible people with antibiotic resistant infections
We expect about 30 people to benefit in the first year of funding, increasing to about 60 people over the next 5 years.
Ceftazidime with avibactam for people with these resistant infections would improve health outcomes and reduce the risk of kidney failure. Ceftazidime with avibactam is currently used in some Health New Zealand hospitals and accessed through Pharmac’s Named Patient Pharmaceutical Assessment (NPPA) process. Progressing this proposal would ensure that eligible people would be able to receive funded treatment.
We expect that funding ceftazidime with avibactam would improve health outcomes for people with these infections and reduce length of hospital stays. It is given in hospital, every 8 hours for a number of days in a row but will reduce the length of time people stay receiving treatment.
Price reduction and brand change for palbociclib
Palbociclib is a medicine for people with advanced breast cancer that is HR-positive, HER2-negative since 2020. About 550 people use this medicine each year.
The Ibrance brand of palbociclib is currently supplied by Pfizer, and we are proposing to change the brand to Palbociclib Pfizer, which is also supplied by Pfizer. There would also be a reduction in price for palbociclib.
Palbociclib Pfizer is made by the same supplier, has been approved by Medsafe, is manufactured at the same site, to the same specifications, and is packaged similarly, to Ibrance. It is a type of medicine called a CDK4/6 inhibitor, which slows down the progression of cancer.
The new brand of palbociclib, Palbociclib Pfizer, would be funded from 1 July 2025. All people receiving palbociclib would need to transition from Ibrance to Palbociclib Pfizer by 1 December 2025. From 1 December 2025 the Ibrance brand would be delisted from the Pharmaceutical Schedule.
