Cancer funding shortfalls are more than a moral and medical failure
This opinion piece was first published in The Post on 27 February 2026.
The Government has been clear about its belief in the social investment approach: spend smartly now to prevent bigger costs later, and help people live productive, independent lives. Nowhere is that philosophy more urgently needed than in New Zealand’s medicines funding system.
The current medicines crisis is often framed as a moral issue: people are missing out on life-saving drugs, and lives are quite literally at stake. That is true. But it’s only half the story. Failing to properly invest in modern cancer medicines is also a failure of economic logic.
Take breast cancer. When treated early and effectively, many people go on to live long, healthy lives – working, paying taxes, caring for families, and contributing to their communities. When treatment is delayed, incomplete, or ineffective, some of those cancers progress to metastatic disease: incurable, far more expensive to manage, and devastating for patients and the workforce alike. This is where the social investment lens matters.
A stark example is the experience of Catherine Cooke, an Auckland mother and businesswoman diagnosed with early-stage triple negative breast cancer (TNBC), one of the most aggressive forms of the disease. Internationally, the immunotherapy drug Keytruda is now standard of care for many people with early-stage TNBC, significantly reducing the risk of recurrence and progression to metastatic cancer.
In New Zealand, however, Pharmac only funds Keytruda for people whose TNBC has already become metastatic. Catherine has had to self-fund the drug, paying in excess of $100,000, simply to give herself the best chance of being cured while her cancer is still treatable.
Catherine’s experience is not an anomaly, it’s the predictable outcome of a medicines funding system stretched beyond its means. There many are other essential breast cancer drugs that are widely used overseas but aren’t yet funded here. Pharmac’s own Options for Investment list shows dozens of proven, cost-effective medicines – including Keytruda for early-stage TNBC – that cannot be funded because the budget is too small. The issue is not a lack of evidence or value. It is a lack of investment. From a finance perspective, this should set off alarm bells.
Treating metastatic breast cancer is vastly more expensive than treating early-stage disease. It often involves years of ongoing therapy, repeated hospital admissions, disability support, and lost productivity. Many people with advanced cancer are forced to leave the workforce entirely, not because they want to, but because their bodies can no longer keep up.
By contrast, funding effective treatments earlier keeps people well, and economically active. It keeps parents parenting, professionals working, volunteers volunteering. It reduces long-term health costs and protects the tax base – an international study has shown that around 75% of the incremental healthcare cost of funding Keytruda is offset through increased tax revenue and reduced benefit payments.
If we know that investing now will prevent greater spending later and prevent human suffering along the way, then choosing not to invest is not fiscally responsible. It is short-term cost shifting, with a much larger bill deferred to the future.
New research published by Breast Cancer Foundation NZ shows just how powerful early treatment can be. In the first national analysis of breast cancer recurrence in Aotearoa, the charity’s report, Rethinking Advanced Breast Cancer: Evidence, experience and opportunities in Aotearoa New Zealand, found that since Herceptin was funded for early-stage HER2-positive breast cancer in 2007, the risk of cancer coming back has halved. There are also now fewer people developing advanced breast cancer from this once-aggressive form of the disease. These real-world results mirror what international studies have shown for years – when we fund the best medicines early, we prevent recurrence, reduce metastasis, and save lives.
As we head towards the next Budget, and in this election year, our political leaders have a genuine opportunity to align government spending with the principles of preventative investment. By increasing Pharmac’s budget, New Zealanders won’t have to lose twice: first to disease, then to economic marginalisation because of a policy gap that should have been fixed.
New Zealanders do not expect unlimited spending. But they do expect common sense. Funding cancer drugs only once a disease has become incurable fails both the compassion test and the cost-benefit test. And that failure sits within a wider pattern of underinvestment – currently NZ spends just 0.4% of GDP on medicines, well below the OECD average of 1.4%
Investing in medicines that stop cancer from progressing is not just about saving lives, though it does that too. It is about keeping New Zealanders contributing, connected, and hopeful. That is an investment worth making.