Total cost of private access to Perjeta cheaper for Auckland women
May 26, 2015
Access to Perjeta, a drug for advanced HER2+ breast cancer not yet funded in the NZ public health system, just got a little easier for Auckland women, with Auckland Hospital joining other areas in allowing eligible patients to access Herceptin through the public system while paying for Perjeta privately (Perjeta is used in conjunction with Herceptin and docetaxel (chemotherapy)).
Previously, patients wanting to pay for Perjeta were told they also had to pay for Herceptin, so kudos to the team at Auckland Hospital for working to address this issue, and also to the NZBCF, BCAC and CANGO for their work on behalf of patients wanting access to this new drug.
While Perjeta isn't cheap, Roche NZ offers an access programme that caps the total cost, giving certainty about total spend. The cost will typically be spread over about 18 months for Perjeta. Roche estimates Around half of patients will respond well enough to reach the capping point – after that, they pay no more for the drug but continue treatment paying only the clinic and doctor costs for receiving their treatment. Treatment would discontinue when the patient’s disease progressed. Patients taking Perjeta whose disease progresses may move on to Kadcyla, another new drug not funded by Pharmac. Roche has a bridging programme that means women moving on to Kadcyla from Perjeta won’t face a big bill for Kadcyla.
Women will need to meet clinical criteria for access to Herceptin and Perjeta, so in the first instance should discuss the treatment with their oncologist. For women suited to Perjeta, the NZBCF recommends women should consider “shopping around”, as prices may vary depending on mark-ups charged at different clinics.
Perjeta is for patients with HER2-positive metastatic breast cancer who have not received previous anti-HER2 therapy or chemotherapy for their metastatic diseases. The drug showed impressive results in the CLEOPATRA clinical trial and has become the standard first-line treatment for advanced HER+ breast cancer in some countries. The NZBCF urges Pharmac to fund this medicine for NZ women.
Next steps for women with advanced HER2+ breast cancer:
1. Talk to your oncologist about whether Perjeta might be suitable for you, and about accessing Herceptin through the public system during private Perjeta treatment.
2. Consider shopping around for the best price for Perjeta
3. Ask your private insurer what they’ll cover (policies change over time, so don’t assume you know the answer)
4. For further information visit cancerinfo.co.nz (site owned by pharmaceutical company Roche) or phone the NZBCF breastcare nurse advice line 0800 BC NURSE (0800 22 68773)