Lung cancer funding data for 2020/21

26 November 2021

Dear [name and contact details withheld]

Request for information

Thank you for your request dated 1 November 2021 under the Official Information Act 1982 (OIA) for information relating to lung cancer treatments funded in financial year[1] 2020/21. On 21 November 2021, you further clarified point 5 of your request as shown below. You requested: 

1. The total medicines budget for the year ended 30th June 2021.
2. The top five cancer drugs (brand name, drug name and cancer type) funded by Pharmac as at the year ended 30th June 2021. 
3. The total budget for cancer treatments for year ended 30th June 2021.
4. The investment (cost) of the lung cancer treatments funded by Pharmac, per;
   1. Erlotinib
   2. Gefitinib
   3. Alectinib 
   4. Pemetrexed 
5. Report for the year ended 30th June 2021
   1. NPPA applications submitted per lung cancer
   2. A list of all those funded AND those that were declined…according to; 
      1. Small Cell Lung Cancer
      2. Non Small Cell Lung Cancer (list by known lung cancer biomarker I.e. ALK, Ros1, EFGR, Her2 etc (See list attached)
      3. Immunotherapy – … how many applications on behalf of patients were for immunotherapy (for example Keytruda – Pembrolizumab)
      4. Mesothelioma
6. The total investment (cost) of the lung cancer treatments funded by Pharmac as at the year ended 30th June 2021.
7. Has a date been set for the RFP per immunotherapy for lung cancer? Or has Pharmac decided better and now negotiating with suppliers according to efficacy of treatment modality and PD-L1 status?  

Funding cancer medicines

1. The Combined Pharmaceutical Budget (CPB) for 2020/21 was $1,045 million. 
2. We are unable to provide a list of the top five cancer drugs by cancer type funded by Pharmac as at the year ended 30th June 2021. This is because the type of cancer being treated is not recorded when claiming funding for a dispensed medicine unless access to that medicine is restricted for one indication (eg through Special Authority), and many medicines listed on the Pharmaceutical Schedule are used to treat different indications (eg different cancers). Therefore, we cannot accurately identify exactly which cancer medicines were dispensed for treating lung cancer. Pharmac’s Year in Review lists the gross pricing for some individual medicines and therapeutic groups. This can be found on our website: pharmac.govt.nz > About > What we do > Year in Review 
3. We cannot provide “the total budget for cancer treatments for year ended 30th June 2021” as no such budget exists. All medicines listed on the Pharmaceutical Schedule or funded via our Exceptional Circumstances framework are funded through the CPB – we do not have a specific budget allocated for cancer treatments. 
4. As requested, please see the table below for the gross cost of funding alectinib, erlotinib, gefitinib, and pemetrexed in financial year 2020/21. 

Gross cost of named cancer medicines dispensed in financial year 2020/21

5. We need additional time to consult about releasing a report of all Named Patient Pharmaceutical Assessment (NPPA) applications for lung cancer submitted, funded, and declined in 2020/21.

We have extended the timeframe for this portion of your request to allow consultation and will provide a response as soon as possible and without undue delay.

Read the follow up response

Please note you have the right, by way of complaint under section 28(3) of the OIA to an Ombudsman, to seek an investigation and review of our decision.

6. For the reasons noted in point 2, we are unable to provide “the total investment (cost) of the lung cancer treatments funded by Pharmac as at the year ended 30th June 2021”. 

Request for proposals (RFP) for immune checkpoint inhibitors for lung cancer

7. Last year, we postponed the planned request for proposals (RFP) for immune checkpoint inhibitors for lung cancer. 

We have not yet decided a date for opening the RFP; we cannot seek an RFP until we are confident that there are sufficient funds to invest in these treatments. We are disappointed that we can’t progress the RFP in the timeframe that we had originally planned however, we are required to stay within our budget. 

Although we have postponed this RFP, new medicine funding applications can be submitted via PharmConnect and the status of existing applications are shown on the Application Tracker(external link) as well as through our online options for investment list(external link). Funding applications specifically for lung cancer treatments can be found at: https://connect.pharmac.govt.nz/apptracker/s/global-search/lung%20cancer(external link)

We trust that this information answers your queries. We are making our information more freely available, so we now publish selected OIA responses (excluding personal details) on our website. Please get in touch with us if you have any questions about this. 

Yours sincerely

Rachel Read
Manager, Policy and Government Services 

[1] Pharmac's financial year runs from 1 July to 30 June.