Why can't our early-stage HER2+ women get the treatment they need?

The Herceptin Riders Peaceful Protest - what was it and why did it happen?

It was about two things - boobs and bikes! Firstly, it was about motorcyclists getting together and having some fantastic fun on some great North Island roads. Secondly, and more importantly, it was about trying to make a positive difference to the lives of HER2+ breast cancer battlers and their families in New Zealand.

Extensive clinical trials involving thousands of women across the world show that for those with HER2 positive breast cancer, the drug Herceptin is effective, in conjunction with chemotherapy, when the recommended 17 treatments are taken. The latest data from these trials after 4 years' follow up shows that the addition of Herceptin to regular chemotherapy decreases the chances of the cancer returning by 52% and reduces the risk of death by 35%. On the basis of this empirical evidence, 24 OECD countries have made the decision to fund the full course of treatment for its women with early stage HER2 positive breast cancer. In doing so, they are sending a clear message to their women in need that they are valued members of their respective societies, and therefore entitled to empirically proven treatment options, to give them the best shot at survival.

Unfortunately, New Zealand is currently NOT one of the 24. Instead, this country's government has opted to be one of just two dissenters. PHARMAC, the government-driven drug funding agency has recommended that DHBs fund only three treatments of Herceptin based upon arguably flawed statistical evidence, gathered from one small clinical trial conducted in Finland, which alleges the 3 treatment course to be as effective as the 17 treatments. A recently published international report showed that of 26 countries surveyed, the only country that has worse access to cancer treatment drugs than New Zealand is Poland. That makes us second from the bottom of the international league table.

What Message Is That Sending To The Women Of New Zealand???

The stark reality is that a partial subsidy still leaves access to the empirically proven course of Herceptin treatment incredibly difficult for many of our affected women.

Some have resorted to drastic financial measures to afford the course, at between $70,000 to $120,000 over and above the minimal subsidy, depending on criteria like geographic location and how much they weigh (yes, really!). For those fortunate enough to be ABLE to resort to drastic measures, it usually means compromising - if not obliterating - any kind of financial stability they have, for the rest of the lives they are fighting so hard to keep. The stress attached to that, and the implications for their long-term financial security (and that of their families) needs no explanation. Sadly, many women in New Zealand don't have any financial resources at all. For them, and their families, a hundred thousand dollars may as well be a hundred million, and finding or raising that kind of money to meet the "shortfall" is something they are not in a position to undertake. It would be a huge ask for anyone. For women who are already struggling with the physical and emotional impact of having life-threatening breast cancer, finding the stamina to raise at least seventy thousand dollars simply isn't realistic. As a consequence, a lot of individual groups out here, up and down the country, have rallied to raise funds within their local communities for their local women who need the treatment. Public humanitarianism and goodwill is an awesome thing, and many who have taken part in it have seen the mountains that move because of it.

BUT HERE'S THE QUESTION...

WHY SHOULD THE RESPONSIBILITY FOR TRYING TO KEEP NEW ZEALAND WOMEN AFFECTED WITH EARLY-STAGE HER2+ BREAST CANCER ALIVE HAVE TO REST WITH THE COMMUNITY?

Depending on the stage and specific type of the disease at diagnosis, women fighting breast cancer across the world have various choices. One is radical surgery, as this photograph of a double mastectomy shows, bravely sanctioned for use here by its recipient. She is still what she has always been - a beautiful, creative, much loved and incredibly gifted woman, and she is still battling beyond this massive step, to keep her life. Many people do not know that even radical surgery is often no guarantee of survival. For many women, the fight is bigger, longer and more painful even than this. Other choices in conjunction with or to pre-empt radical surgery include chemotherapy, radiation therapy and, for women in almost every OTHER so-called "civilized society", no matter what stage their HER2+ breast cancer is at, the drug Herceptin. Here, unless they are in advanced stages, New Zealand women don't qualify.

Why Not?

Most people would agree that breast cancer is a stressful enough monster to have to go head to head with, to take on and get through, without being faced at the same time with the choice of having to accept the status quo (with its implications of a life cut brutally short), placing faith in community goodwill (which cannot be comfortable for many recipients to accept either) or stepping into the ring with a government who thus far seems unperturbed at adding the challenge of yet another round of hurdles to the already obstacle-littered landscape of its suffering women. A growing number of people- women AND men - want this situation to change. Women with breast cancer already have enough of a challenge to face, just trying to stay alive.

A group of 8 women with HER2+ early stage breast cancer have been successful in obtaining a judicial review of PHARMAC's current decision. The review took place in February 2008. We are still awaiting the outcome.

2008 IS AN ELECTION YEAR! FOR MANY PEOPLE, HERCEPTIN FUNDING IS AN ELECTION ISSUE.