Funding process for child cancer medicines to remain

Media release Medicines

Pharmac – Te Pātaka Whaioranga has decided to keep Rule 8.1b, which allows medicines for treating children with cancer to be automatically funded without Pharmac assessment.

“We’ve heard very clearly from clinicians and the whānau of child and adolescent cancer patients that Rule 8.1b has a real impact on treatment and health outcomes,” says Dr David Hughes, Pharmac’s Chief Medical Officer and Director of Advice and Assessment.

“Most children with cancer will be treated with medicines already funded through the Pharmaceutical Schedule but for a small number of children each year, Rule 8.1b gives their doctors access to medicines that Pharmac hasn’t assessed.

“This means that children with cancer can receive the rapid, life-saving treatment they need when it will make the most difference.”

The decision to keep Rule 8.1b means that all medicines currently being funded for child cancer patients will continue to be funded. It also means that the Rule 8.1b exception will continue to apply to new paediatric cancer medicines where clinicians decide that these are the best option for their patients and the medicines are not already funded.

About 150 children are diagnosed with cancer each year, and up to 15 a year will need to access medicines using Rule 8.1b.

The decision to keep Rule 8.1b follows a lengthy public consultation. Pharmac received 86 submissions from individuals, whānau with children or adolescents and young adults who are having or have had cancer treatment, clinicians and clinical networks, patient advocacy groups, and other health-related organisations.

“It’s difficult for many people to talk about their experience of supporting a child with cancer and we are very grateful for the feedback we received,” says Dr Hughes. “This feedback affirmed the value of Rule 8.1b as an essential part of the clinical pathway for child cancer patients and it’s helped us identify areas for further improvements.”

Dr Hughes says the next steps for Pharmac include working with clinicians and patient groups to:

  • Improve governance and oversight of the treatment decisions made under Rule 8.1b.
  • Develop ways to manage new and emerging therapies so they are financially sustainable.
  • Consider options in our current budget to improve access to treatment for adolescents and young adults with a paediatric-type cancer, whether they are treated in a paediatric or adult cancer service.

Pharmac’s Board will consider further options to improve Rule 8.1b later this year.