Delaying funding medicines for lung cancer patients – is it fair?


30 October 2020, Merck Sharp & Dohme New Zealand Limited (MSD) says the new government is understandably continuing to spend billions on protecting New Zealanders from the economic and health impacts of COVID-19; but asks, is it fair, that at the same time, high numbers of their fellow New Zealanders with lung cancer continue to not have access to funded immunotherapy medicines.

Every year lung cancer continues to kill more New Zealanders than melanoma, breast and prostate cancer combined.1

MSD New Zealand Director, Mr Paul Smith, says “We acknowledge these are unprecedented times and taxpayer money is under pressure. We also welcome this government’s pre-election commitment to make some increase to PHARMAC budgets. But we urge New Zealanders to ask their political leaders if they think it is fair to continue to withhold funded access to immunotherapy treatments for these patients?

In August 2019, PHARMAC announced plans to look at funding immunotherapy treatments for lung cancer, but put them on hold in April this year, citing the impact of COVID-19.2

“Many people I have spoken to, say it is hard to understand why the government is prepared to spend $NZ 75 million on horse racing, while each year around 1,700 New Zealanders with lung cancer pass away without funded access to immunotherapies, which are available and funded in many countries around the world.3,1,4

“PHARMAC has put the funding for these treatments on hold. But waiting isn’t an option for lung cancer patients, as approximately only one in seven of those with advanced disease are still alive after one year.5

“The process to fund an immunotherapy medicine is moving too slowly in our opinion, and in the meantime another 34 New Zealanders with lung cancer die every week.1

“This is in stark contrast to Australia, which funds a range of immunotherapies for lung cancer patients. In New Zealand chemotherapy remains the only funded option for four out of five patients.” 6,7

Lung Foundation New Zealand CEO, Mr Philip Hope, endorses the call for more government and political attention to the needs of New Zealanders with lung cancer and for PHARMAC to be given adequate funding to reimburse treatments for New Zealand’s biggest cancer killer.

“For patients diagnosed with lung cancer, access to immunotherapy treatments could put them on par with patients from other countries. The inequities surrounding lung cancer in New Zealand are extreme. Only a small percentage of patients with the financial means can access, what is standard of care treatments in other countries.8

“This injustice is the direct result of cost-cutting and policy settings by government regarding pharmaceutical investment. Consequently, New Zealand is well below comparable OECD countries, including Australia, when it comes to access to innovative medicines.9

“As for the Crown’s responsibility to Māori, under Article 3 of the Treaty, the biggest source of cancer mortality for Māori is being almost completely ignored. This lack of commitment is indefensible and unacceptable.10

“Immunotherapy medicines were funded in 2016 for melanoma, which predominantly effects non-Maori. Yet lung cancer patients have been waiting nearly four years and there is no date set for PHARMAC to relook at issuing the proposal to fund lung immunotherapy medicines.”11,12

November is lung cancer awareness month, and MSD is running an advertising campaign which highlights the need for New Zealand patients to have access to more funded lung cancer treatments.

-ENDS-

If you would like to arrange an interview with MSD New Zealand Director, Paul Smith or Lung Foundation New Zealand CEO Philip Hope: Please contact Sheryl Kurte on +64 21 281 7584

About MSD

For more than 125 years, MSD has been inventing for life, bringing forward medicines and vaccines for many of the world’s most challenging diseases in pursuit of our mission to save and improve lives. MSD is a trade name of Merck & Co., Inc., Kenilworth, N.J., U.S.A. We demonstrate our commitment to patients and population health by increasing access to health care through far-reaching policies, programs and partnerships. Today, MSD continues to be at the forefront of research to prevent and treat diseases that threaten people and animals – including cancer, infectious diseases such as HIV and Ebola, and emerging animal diseases – as we aspire to be the premier research-intensive biopharmaceutical company in the world. For more information, visit www.msd-newzealand.com and connect with us on Twitter @FightCancerNZ

NZ-KEY-00328 References:
  1. New Zealand Ministry of Health Mortality Tables 2017
  2. PHARMAC website – Immune checkpoint inhibitors for lung cancer postponed. Last accessed October 2020 https://www.pharmac.govt.nz/medicines/new-medicines/immune-checkpoint-inhibitors-for-lung-cancer-postponed/
  3. New Zealand Government Website Beehive.govt.nz media release. Last accessed October 2020 www.beehive.govt.nz/release/emergency-support-racing’s-recovery
  4. MSD data on file
  5. NZ MOH Data on request
  6. PBS website. www.pbs.gov.auLast accessed October 2020
  7. McKeage et al Technical Report for the Health Innovation Partnership 2015
  8. NCCN Clinical Practice Guidelines in Oncology NSCLC September 2020
  9. Medicines Australia Comparison of Access and Reimbursement Environments (Compare) edition 4 2018
  10. MOH New Zealand Cancer Action Plan 2019-2029
  11. PHARMAC notice 2 August 2016
  12. MOH Website - Melanoma. https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/melanomaLast accessed October 2020


Copyright © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. All rights reserved. Merck Sharp & Dohme (New Zealand) Pty Limited. Level 3,123 Carlton Gore Road, Newmarket, Auckland. All rights reserved. NZ-KEY-00562 TAPS NA12366 First Issued October 2020

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Important Safety Information

KEYTRUDA® (pembrolizumab) is available as a 50mg powder for infusion and 100 mg/4 mL concentrate for solution for infusion.

Additional product information and the KEYTRUDA Consumer Medicine Information (CMI) can be obtained by phoning MSD on 0800 500 673 or is available at www.medsafe.govt.nz.

KEYTRUDA contains the active substance called pembrolizumab and is a medicine that may treat certain cancers by working with your immune system.

KEYTRUDA can only be used in children below 18 years of age with cHL, or MSI-H or dMMR cancers. It is not known if KEYTRUDA is safe and effective in children with MSI-H or dMMR cancer of the brain or spinal cord (central nervous system cancers).

Tell your doctor if you have a disease of your immune system such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or have had a bone marrow (stem cell) transplant that used donor stem cells (allogeneic); have pneumonia or swelling of your lungs (called pneumonitis); have liver problems; or have any other medical problems.

If you are pregnant, think you may be pregnant or are planning to have a baby, tell your doctor. KEYTRUDA can harm your unborn baby. Effective contraception must be used during treatment with KEYTRUDA and for at least 4 months after the last dose of KEYTRUDA for woman who could become pregnant.

If you are breastfeeding, tell your doctor. Do not breastfeed while taking KEYTRUDA.

Tell your doctor if you are taking any other medicines, including medicines that can be bought without a prescription from a pharmacy, supermarket or health food shop, or other medicines that make the immune system weak. Examples of these may include steroids, such as prednisone.

KEYTRUDA is given through an IV for about 30 minutes. Most people get KEYTRUDA every 3 weeks or every 6 weeks, depending on age and the dose given. Your doctor will decide how many treatments you need. KEYTRUDA may be given in combination with other anti-cancer medicines.

What are the possible side effects of KEYTRUDA?

KEYTRUDA can have some serious side effects. These side effects can sometimes become life-threatening and can lead to death. These side effects may happen any time during treatment or even after treatment has ended. More than one side effect can be experienced at the same time.

Call or see your doctor right away if you develop any of the following symptoms:

Lung problems. Signs and symptoms of lung problems may include shortness of breath, chest pain, or coughing.

Intestinal problems. Signs and symptoms of problems with your intestines may include diarrhea or more bowel movements than usual, stools that are black, tarry, sticky, or have blood or mucus, or severe stomach pain or tenderness.

Liver problems. Signs and symptoms of liver problems may include nausea or vomiting, feeling less hungry, pain on the right side of your stomach, your skin looks yellow, the whites of your eyes look yellow, dark urine or you bleed or bruise more easily than normal.

Hormone gland problems (especially the thyroid, pituitary, adrenal glands). Signs and symptoms of hormone gland problems may include rapid heartbeat, weight loss or weight gain, increased sweating, hair loss, feeling cold, constipation, your voice gets deeper, muscle aches, dizziness or fainting, or headaches that will not go away or unusual headache.

Kidney problems. Signs and symptoms of kidney problems may include change in the amount or color of your urine.

Skin problems. Signs and symptoms of skin problems may include rash, itching, blisters, peeling or skin sores, or ulcers in mouth or in lining of nose, throat, or genital area.

Problems in other organs. Signs and symptoms of problems in other organs may include muscle pain or weakness, changes in eyesight, stomach area pain with nausea and vomiting (pancreatitis), shortness of breath, irregular heartbeat, feeling tired, or chest pain (myocarditis), confusion, fever, memory problems, or seizures (encephalitis), swollen lymph nodes, rash or tender lumps on skin, cough, or eye pain (sarcoidosis), or pain, numbness, tingling, or weakness in the arms or legs; bladder or bowel problems including needing to urinate more frequently, urinary incontinence, difficulty urinating and constipation (myelitis).

Infusion (IV) reactions. Signs and symptoms of infusion reactions may include shortness of breath, itching or rash, dizziness or fever.

Rejection of a transplanted organ. People who have had an organ transplant may have an increased risk of organ transplant rejection. Your doctor should tell you what signs and symptoms you should report and monitor you, depending on the type of organ transplant that you have had.

Graft-versus-host-disease (GVHD) in people with bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). GVHD may occur if you had this transplant in the past. Your doctor will monitor you for the following signs and symptoms: skin rash, liver inflammation, abdominal pain, and diarrhoea.

Common side effects:

Very common side effects (may affect more than 1 in 10 people) include: diarrhoea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of skin which have lost colour, stomach pain and decreased sodium levels in the blood.

Common side effects (reported in more than 1 in 5 people) when KEYTRUDA was given in combination with chemotherapy include: hair loss, feeling tired, diarrhoea, decrease in white blood cell count, joint pain and rash.

The most common side effects when KEYTRUDA is given in combination with axitinib are: diarrhoea, high blood pressure, fatigue, low levels of thyroid hormone, decreased appetite, blisters or rash on the palms of your hands or soles of your feet, nausea, increase in liver enzyme levels, hoarseness, cough and constipation.

The most common side effects when KEYTRUDA is given alone to children are: fever, vomiting, headache, stomach pain, decrease in number of red blood cells, cough, and constipation.

Less common side effects can happen. KEYTRUDA may cause other side effects that are not listed. If you have any side effect that bothers you or that does not go away, tell your doctor.

For more information, please talk to your doctor.

KEYTRUDA is a funded medicine for the treatment of melanoma which has spread and cannot be removed by surgery – restrictions apply. KEYTRUDA is an unfunded medicine for the treatment of melanoma after surgery, NSCLC, HNSCC, cHL, urothelial carcinoma, MSI-H/dMMR cancer and RCC.

KEYTRUDA has risks and benefits. Talk to your doctor to see if KEYTRUDA is right for you. Ask your health professional about the cost of the medicine and any other medical fees that may apply. Use only as directed and if symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

Based on the CMI prepared 12 November 2020.

Merck Sharp & Dohme (New Zealand) Limited. Level 3, 123 Carlton Gore Road, Newmarket, Auckland. NZ-KEY-00522 DA 2045KN Updated December 2020


KEYTRUDA® (pembrolizumab) Indications and Important Safety Information

KEYTRUDA® (pembrolizumab) is available as a 50mg powder for infusion and 100 mg/4 mL concentrate for solution for infusion.

Additional product information and the KEYTRUDA Consumer Medicine Information (CMI) can be obtained by phoning MSD on 0800 500 673 or is available at www.medsafe.govt.nz.

KEYTRUDA is a Prescription Only Medicine and is used to treat:

  • a kind of skin cancer called melanoma
  • a kind of lung cancer called non-small cell lung cancer (NSCLC)
  • a kind of cancer called classical Hodgkin Lymphoma (cHL)
  • a kind of cancer called urothelial carcinoma, including bladder cancer
  • a kind of head and neck cancer called head and neck squamous cell carcinoma (HNSCC)
  • a kind of cancer in adults and children that can occur in any part of the body and is shown by a laboratory test to be microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR)
  • a kind of cancer called renal cell carcinoma (RCC)

KEYTRUDA contains the active substance called pembrolizumab and is a medicine that may treat certain cancers by working with your immune system.

KEYTRUDA can only be used in children below 18 years of age with cHL, or MSI-H or dMMR cancers. It is not known if KEYTRUDA is safe and effective in children with MSI-H or dMMR cancer of the brain or spinal cord (central nervous system cancers).

Tell your doctor if you have a disease of your immune system such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or have had a bone marrow (stem cell) transplant that used donor stem cells (allogeneic); have pneumonia or swelling of your lungs (called pneumonitis); have liver problems; or have any other medical problems.

If you are pregnant, think you may be pregnant or are planning to have a baby, tell your doctor. KEYTRUDA can harm your unborn baby. Effective contraception must be used during treatment with KEYTRUDA and for at least 4 months after the last dose of KEYTRUDA for woman who could become pregnant.

If you are breastfeeding, tell your doctor. Do not breastfeed while taking KEYTRUDA.

Tell your doctor if you are taking any other medicines, including medicines that can be bought without a prescription from a pharmacy, supermarket or health food shop, or other medicines that make the immune system weak. Examples of these may include steroids, such as prednisone.

KEYTRUDA is given through an IV for about 30 minutes. Most people get KEYTRUDA every 3 weeks or every 6 weeks, depending on age and the dose given. Your doctor will decide how many treatments you need. KEYTRUDA may be given in combination with other anti-cancer medicines.

What are the possible side effects of KEYTRUDA?

KEYTRUDA can have some serious side effects. These side effects can sometimes become life-threatening and can lead to death. These side effects may happen any time during treatment or even after treatment has ended. More than one side effect can be experienced at the same time.

Call or see your doctor right away if you develop any of the following symptoms:

Lung problems. Signs and symptoms of lung problems may include shortness of breath, chest pain, or coughing.

Intestinal problems. Signs and symptoms of problems with your intestines may include diarrhea or more bowel movements than usual, stools that are black, tarry, sticky, or have blood or mucus, or severe stomach pain or tenderness.

Liver problems. Signs and symptoms of liver problems may include nausea or vomiting, feeling less hungry, pain on the right side of your stomach, your skin looks yellow, the whites of your eyes look yellow, dark urine or you bleed or bruise more easily than normal.

Hormone gland problems (especially the thyroid, pituitary, adrenal glands). Signs and symptoms of hormone gland problems may include rapid heartbeat, weight loss or weight gain, increased sweating, hair loss, feeling cold, constipation, your voice gets deeper, muscle aches, dizziness or fainting, or headaches that will not go away or unusual headache.

Kidney problems. Signs and symptoms of kidney problems may include change in the amount or color of your urine.

Skin problems. Signs and symptoms of skin problems may include rash, itching, blisters, peeling or skin sores, or ulcers in mouth or in lining of nose, throat, or genital area.

Problems in other organs. Signs and symptoms of problems in other organs may include muscle pain or weakness, changes in eyesight, stomach area pain with nausea and vomiting (pancreatitis), shortness of breath, irregular heartbeat, feeling tired, or chest pain (myocarditis), confusion, fever, memory problems, or seizures (encephalitis), swollen lymph nodes, rash or tender lumps on skin, cough, or eye pain (sarcoidosis), or pain, numbness, tingling, or weakness in the arms or legs; bladder or bowel problems including needing to urinate more frequently, urinary incontinence, difficulty urinating and constipation (myelitis).

Infusion (IV) reactions. Signs and symptoms of infusion reactions may include shortness of breath, itching or rash, dizziness or fever.

Rejection of a transplanted organ. People who have had an organ transplant may have an increased risk of organ transplant rejection. Your doctor should tell you what signs and symptoms you should report and monitor you, depending on the type of organ transplant that you have had.

Graft-versus-host-disease (GVHD) in people with bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). GVHD may occur if you had this transplant in the past. Your doctor will monitor you for the following signs and symptoms: skin rash, liver inflammation, abdominal pain, and diarrhoea.

Common side effects:

Very common side effects (may affect more than 1 in 10 people) include: diarrhoea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of skin which have lost colour, stomach pain and decreased sodium levels in the blood.

Common side effects (reported in more than 1 in 5 people) when KEYTRUDA was given in combination with chemotherapy include: hair loss, feeling tired, diarrhoea, decrease in white blood cell count, joint pain and rash.

The most common side effects when KEYTRUDA is given in combination with axitinib are: diarrhoea, high blood pressure, fatigue, low levels of thyroid hormone, decreased appetite, blisters or rash on the palms of your hands or soles of your feet, nausea, increase in liver enzyme levels, hoarseness, cough and constipation.

The most common side effects when KEYTRUDA is given alone to children are: fever, vomiting, headache, stomach pain, decrease in number of red blood cells, cough, and constipation.

Less common side effects can happen. KEYTRUDA may cause other side effects that are not listed. If you have any side effect that bothers you or that does not go away, tell your doctor.

For more information, please talk to your doctor.

KEYTRUDA is a funded medicine for the treatment of melanoma which has spread and cannot be removed by surgery – restrictions apply. KEYTRUDA is an unfunded medicine for the treatment of melanoma after surgery, NSCLC, HNSCC, cHL, urothelial carcinoma, MSI-H/dMMR cancer and RCC.

KEYTRUDA has risks and benefits. Talk to your doctor to see if KEYTRUDA is right for you. Ask your health professional about the cost of the medicine and any other medical fees that may apply. Use only as directed and if symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

Based on the CMI prepared 12 November 2020.

Merck Sharp & Dohme (New Zealand) Limited. Level 3, 123 Carlton Gore Road, Newmarket, Auckland. NZ-KEY-00522 DA 2045KN Updated December 2020 

Copyright © 2019 - 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. All rights reserved.