Pharmac reverses eligibility restrictions for life-extending drugs

Since February, Breast Cancer Foundation NZ have been asking Pharmac to review its ‘one drug per lifetime’ rule for CDK 4/6 inhibitors. This rule has prevented patients switching between two life-extending drugs in situations where a patient experiences treatment-ending side effects.

Today, after months of discussion, we’re thrilled to announce Pharmac has taken onboard our feedback and have changed the criteria for two breast cancer medicines.

From 1 July, ribociclib (branded as Kisqali) will be funded for advanced hormone receptor-positive, HER2- breast cancer. Palbociclib (branded as Ibrance) has been funded for this type of breast cancer since 2020. If a patient suffered severe side effects on Ibrance and has had no progression of their disease, they will now be able to access Kisqali, and vice versa.

Initially when the funding of ribociclib (Kisqali) was announced, patients would not be able to switch between funded CDK4/6 inhibitors if they were experiencing severe side effects. As part of their consultation process, Pharmac invited us to meet with them in Wellington to discuss our concerns. They took this back to their clinical advisors, who agreed it’s the right thing to do.

Adèle Gautier, research and strategic programmes manager at Breast Cancer Foundation NZ, praised the decision, saying it “makes total sense... One of the main benefits of having a second type of CDK4/6 inhibitor publicly funded is the ability to switch between them if a patient must stop one. It means doctors won’t have to second guess what types of side effects patients will get that will make them stop treatment.”

“We are aware of patients who have had to stop treatment due to side effects. For them, today’s news brings welcome relief and hope.”

Ah-Leen Rayner, chief executive of Breast Cancer Foundation NZ, says, “It’s great that Pharmac has listened to our feedback and has acted on it.”

“This is going to make a big difference to people experiencing severe side effects on this type of drug. It will help them to stay on these valuable, life-extending treatments for longer, while avoiding chemotherapy for as long as possible.”