PHARMAC and Herceptin for early-stage breast cancer in New Zealand: Herceptin or deception?

Pressure to fund Herceptin (trastuzumab) for use in early-stage breast cancer is a welcome development for those patients who may benefit. However such a decision would have major implications since the health gains made by trastuzumab come at a very high cost (when compared to health gains achieved by other drugs currently funded on PHARMAC's schedule). The budget for trastuzumab (estimated to be NZ30m dollars/annum but this is currently being negotiated) will be funded from district health board (DHB) budgets, which will impact other patients unless DHB budgets are appropriately increased. In comparative terms, this proposed expenditure is almost the same as what is currently being spent on all other oncology agents together, and is similar to the total cost of hospital services in New Zealand regions such as Wairarapa and Marlborough.