Brain tumour patients to gain greater access to expensive drug

People with brain tumours are to have greater access to an expensive cancer drug from 1 December.

Temozolomide (Temodal) has been funded since 2005 for patients newly diagnosed with the most advanced forms of brain tumour, called glioblastoma multiforme. In the changes to take effect from 1 December, PHARMAC will expand funded access to also include newly diagnosed patients with anaplastic astrocytoma, a less advanced form of brain tumour.

Medical director Dr Peter Moodie says the access widening comes after a funding application from doctors on which PHARMAC sought advice from a committee of cancer specialists.

“We have had a number of applications from doctors to widen access to temozolomide since it was first funded,” says Dr Moodie. “To consider these applications, we sought further advice from the committee. Their view was that anaplastic astrocytoma and glioblastoma multiforme were clinically very similar, and so the funded access criteria should be widened to accommodate both.”

Dr Moodie adds that the committee considered that other applications to widen access, such as increasing the number of funded treatment cycles, or providing funding for relapsed disease, should be declined.

“The committee did not consider there to be sufficient evidence to support widening funding for these other uses,” he says.

Anaplastic astrocytomas are relatively rare, with PHARMAC predicting that about 15 or 16 patients will require funded temozolomide treatment each year.

“Aggressive brain tumours can be difficult to treat, with de-bulking surgery, radiation treatment and chemotherapy the only real options available. Temozolomide can make a real difference to these types of brain tumours and help people live longer.”

“However, temozolomide is still an expensive treatment with treatment courses costing around $30,000, so we do need to ensure that this spending is targeted at the people most likely to benefit, based on the available evidence.”

PHARMAC expects less expensive, generic brands of temozolomide to be available within the next five years.

Dr Moodie says doctors using temozolomide to treat patients with newly diagnosed anaplastic astrocytoma will need to gain their informed consent under Section 25 of the Medicines Act, as temozolomide is not approved by Medsafe for this use.

“Cancer doctors are very familiar with using medicines outside their registered indications so this should not present a problem for them,” he says.