Pharmac anounces huge step forward in cancer drug-funding process - Dr Ruth Spearing


Last week the minister responsible for Pharmac David Seymour announced that the agency would be able to consider applications for funding of a drug at the same time as it is being considered by Medsafe.

This is a good step forward in speeding up the process of getting new cancer drugs to New Zealanders.

The Government has also promised that the top 13 drugs recommended for funding by the European Society for Medical Oncology will be funded.

This is also good progress but unfortunately this list did not include any drugs for patients with blood cancers, as the society has not yet reviewed these drugs.

This creates a real equity issue: an estimated 21,000 New Zealanders are currently living with blood cancer and every day eight children and adults in New Zealand are diagnosed with a blood cancer. The plight of many quite young patients living with myeloma has recently been highlighted and it is important that this group of patients is not overlooked.

Addressing this issue is one of many substantial reforms of Pharmac that are essential if New Zealand is to move towards having similar access to lifesaving medicines as other countries with a similar GDP per capita.

Thousands of patients suffering from blood cancer will not benefit from the new drugs.

One high priority for reform that is less well understood by the public is the negative impact the chronic underfunding and the lack of flexibility of Pharmac has had on New Zealand’s ability to take part in groundbreaking clinical trials.

New Zealand is so far behind the rest of the OECD countries that the “standard of care” drugs against which these new drugs are benchmarked in the trials are not funded, and so, sadly, these groundbreaking trials are now increasingly not offered to New Zealand.

Particularly important are clinician-initiated trials (as opposed to pharmaceutical company trials), as they will look not only at new drugs but also, for example, the use of new molecular or imaging techniques to assess response, enabling some treatment courses to be safely shortened, with fewer associated side-effects and less cost. On very rare occasions Pharmac has supported such trials.

As an example, Pharmac approved the District Health Boards purchasing a drug which enabled New Zealand to take part in an international trial for Acute Myeloid Leukaemia, run out of the United Kingdom.

This decision paid off very well, with the DHBs needing to undertake fewer highly expensive stem cell transplants, gaining $4.5 million of free, now FDA-approved drugs, $76,000 worth of free molecular testing, and the best outcomes for this devastating condition that New Zealand has ever had.

The outstanding return on investment on these types of trials is supported by independent studies such as the KPMG report into Australian clinical research which concluded clinician-initiated trials delivers outstanding return on investment with a $78 billion net gain to the Australian economy. One trial had a massive return of 6,465 per cent.

Why would any organisation or country not invest in and support health-related activities with such a return?

However, when the results and financial gains of the UK leukaemia trial were presented to the chief executive of Pharmac, Sarah Fitt, her reaction was “that isn’t something Pharmac will be doing again”. Sadly, as a result, that was the last of the UK Acute Myeloid Leukaemia trials that New Zealand has been able to offer patients.

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Support of these clinical trials is of paramount importance as they save lives - and money. It’s a win-win for all. Greater flexibility within Pharmac and within Health New Zealand to support national trials is essential.

Leaders from the Australasia’s leading blood cancer research group, the Australasian Leukaemia and Lymphoma Group, are gathering in Wellington next week to discuss clinical trials in NZ.

They will be making the case for these changes. It is to be hoped that, with vision and appreciation of both the health and economic value of clinical trials, the Government will seize the opportunity to support this critical pathway to improving life outcomes for New Zealand patients.

Dr Ruth Spearing, CNZM, is a haematologist and medical researcher for blood cancers



Dr Ruth Spearing - Why reform of Pharmac is vital

Dr Ruth Spearing, CNZM, is a haematologist and medical researcher for blood cancers, and a trustee for CLL Advocates NZ.


OPINION: Late last year, many of my colleagues returned from the largest international gathering of doctors who treat blood disorders.

We are living in exciting times in terms of potential treatments for these cancers which include leukaemia, myeloma and lymphoma. The research done by the joint efforts of clinicians, scientists and patients together has shown that many cancers can now be completely cured or at least controlled for increasingly long periods of time.

Read the full article here: Dr Ruth Spearing - Why reform of Pharmac is vital

Combo of drugs could be used to treat Chronic Lymphocytic Leukaemia patients

A medicine regime that can be taken at home could mean patients suffering from chronic lymphocytic leukaemia will be much less likely to need hospital chemotherapy.

About 320 people are diagnosed in New Zealand each year with chronic lymphocytic leukaemia - referred to as CLL.

It is the most common form of leukaemia in this country.

But two major leukaemia studies presented at a recent global blood cancer conference in December, the American Society of Haematology, have shown the use of the drug IMBRUVICA in combination with venetoclax can be successful as a first option of treatment for CLL patients.

The drugs have been used to treat CLL separately but the two recent studies - named CAPTIVATE and GLOW - found their combination was highly successful in treating patients.

Patients took the drugs over 15 months and 97 per cent in one study and 84.5 per cent in the other were still alive after five years.

Listen to haematologist Dr Sharon Jackson from Middlemore Hospital and patient Kylie Soo, who is now in remission discuss the treatment regime: Combo of drugs could be used to treat leukaemia patients

Incidence of Non-Melanoma Skin Cancers in Patients with CLL: A Retrospective Study in Bay of Plenty New Zealand Population

CLLANZ provided some assistance for a research project to be done as a summer studentship, by then fifth year medical student, Andrew Weston, on “second primary malignancies in NZ CLL patients”.

Here is the link to the abstract published at the 63rd ASH (The American Society of Hemotology) Annual Meeting.

Second primary malignancies are important in CLL, where the impaired immune system is not as able to deal to developing malignancies as people with normal immune systems can. As a consequence, about one third of CLL patients die of a second primary malignancy, such as melanoma, colon cancer, and pancreatic cancer. Some of these cancers have well-recognised screening procedures to detect early stage cancers, which can have a better outcome to treatment then, compared to when they are picked up when symptoms develop.

Regular skin checks, and colonoscopy are two good examples of this screening approach.

NZ patients contribute to research for future treatment for leukaemia in global studies

At the American Society of Haematology (ASH) conference, significant research on chronic lymphocytic leukaemia (CLL) was unveiled, capturing the attention of New Zealand's haematologists and researchers. The studies focused on the extended monitoring of a chemo-free, fixed-duration, oral treatment approach for CLL patients, offering promising insights into a potentially groundbreaking first-line therapy. This research marks a pivotal advancement in understanding CLL treatment, highlighting the potential for more effective and manageable approaches in combating this form of leukaemia.

Please read more here: Media Release - Research for Future CLL Treatment

Coalition Agreement


Yesterday coalition agreements between the National Party and New Zealand First and Act were formally signed. This three-party coalition promises to shape one of the most unique Cabinets under the MMP system, emphasising a cross-party approach to governance.

The Coalition Agreements, available by clicking here for National and NZ First and here for National and Act, outline the shared commitments and collaborative efforts that will define the upcoming Government.


Prime Minister and Deputy Prime Minister

Christopher Luxon will be the Prime Minister.

Winston Peters will be Deputy Prime Minister until May 31 2025.

David Seymour will be Deputy Prime Minister from May 31 2025.

Minister of Health, Associate Ministers of Health & Minister of Science and Innovation

Dr Shane Reti - Minister of Health
David Seymour - Associate Minister of Health (Pharmac)
Matt Doocey - Associate Minister of Health

Casey Costello - Associate Minister of Health


Key Health Items from Coalition Agreements

Between National and Act

  • Disestablish the Māori Health Authority
  • Repeal the Therapeutic Products Act 2023
  • Broaden the terms of reference of the Royal Commission into the COVID-19 response, subject to public consultation.
  • Update Pharmac’s decision making model to ensure it appropriately takes patient voice into account and reform the funding model to account for positive fiscal impacts on the Crown of funding more medicines.
  • Require the Ministry of Health to publish a Medicines Strategy every three years.
  • Require Medsafe to approve new pharmaceuticals within 30 days of them being approved by at least two regulatory agencies recognised by New Zealand.
  • Better recognise people with overseas medical qualifications and experience for accreditation in New Zealand, including consideration of an occupations tribunal.
  • Investigate build and lease-back arrangements for New Hospitals.
  • Allow the sale of cold medication containing pseudoephedrine.
  • Allow appropriately qualified pharmacists to directly prescribe certain treatments.
  • Agree the terms of reference for the statutory requirement to review the End of Life Choice Act 2019 following consultation between the Parties, with any potential future changes to be progressed by way of a member’s bill, recognising this is a conscience issue.
  • Examine the Māori and Pacific Admission Scheme (MAPAS) and Otago equivalent to determine if they are delivery desired outcomes.
  • Repeal the Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act 2022 to remove the requirements for denicotinisation and the reduction in retail outlets.
  • Introduce serious penalties for selling vapes to under 18s and consider requiring a liquor licence to sell vapes.


Between National and New Zealand First

  • Abolish the Māori Health Authority
  • Update Pharmac’s decision making model to ensure it appropriately takes “patient voice” into account and increase funding for Pharmac every year
  • Require Medsafe to approve new pharmaceuticals within 30 days of them being approved by at least two overseas regulatory agencies recognised by New Zealand.
  • Better recognise people with overseas medical qualifications, and experience for accreditation in New Zealand.
  • Progress the adoption of digital technology in harder to staff areas and make greater use of Nurse Practitioners.
  • Repeal the Therapeutic Products Act 2023.
  • Fund Gumboot Friday / I am Hope Charity to $6 million per annum
  • Renegotiate Crown funding agreement with St John with a view to meeting a greater portion of their annualised budget.
  • Ensure Plunket is funded to do their job properly
  • Ensure proper funding for birthing units and maternity care, including providing a three day stay for new mothers.
  • Repeal amendments to the Smokefree Environments and Regulated Products Act 1990 and regulations before March 2023, removing requirements for denicotisation ,removing the reduction in retail outlets and the generation ban, while also amending vaping product requirements and taxing smoked products only.


Calls to sack Pharmac boss after 'sick, sneering' remarks

Our CLL Advocates Media Release has made it to Stuff! Well done Ruth Spearing, CLL Trustee and passionate advocate.

Ruth Spearing, haematologist and trustee of Chronic Lymphocytic Leukaemia Advocates, has called on Health Minister Ayesha Verrall, State Services Commissioner Peter Hughes and Pharmac chairperson Steve Maharey to demand Fitt’s resignation.

Read more here: Calls-to-sack-pharmac-boss-after-sick-sneering-remarks





Dr Ruth Spearing, haematologist and Trustee of Chronic Lymphocytic Leukaemia Advocates NZ, today called for the resignation of Pharmac CEO Sarah Fitt over revelations in internal emails released under the Official Information Act. The emails concerned journalist and outspoken critic of Pharmac, Rachel Smalley.

Dr Spearing said the emails revealed a sick, sneering culture inside Pharmac and a disgraceful attitude towards a person who has had the courage to speak out on behalf of patients who have been waiting years for Pharmac decisions on medicines.

“Sarah Fitt’s comments are not just unprofessional, they are deeply offensive, and demonstrate that she is entirely unfit to manage an organisation that has control over the lives and wellbeing of thousands of New Zealanders.

“It’s clear that Ms Fitt has created a crude, jokey clique among senior Pharmac staff, swapping childish, insulting remarks about Ms Smalley, even to the extent of composing a limerick about her.

“I call on Health Minister Ayesha Verrall, State Services Commissioner Peter Hughes and Pharmac Chair Steve Maharey to show that this behaviour by the leader of a government agency cannot be tolerated, and to demand her immediate resignation,” said Dr Spearing.

Rachel Smalley: Inside the minds of Pharmac’s leadership team - NZ Herald

For further information contact:

Dr Ruth Spearing CNZM, MBChB, FRACP, FRCPA


Chronic Lymphocytic Leukaemia Advocates NZ

027 512 6356

About CLL Advocates NZ – CLL Advocates NZ

About Dr Ruth Spearing

Dr Ruth Spearing CNZM, MBChB, FRACP, FRCPA has been involved with haematology since 1980 and has been a leader nationally in haematology trials. She was the NZ Principal Investigator for many of the UK Medical Research Council/National Cancer Research Institute trials which New Zealand took part in from the late 1980s until two years ago. These included the first ever trial to show that treatment of CLL could lead to prolongation of life and not just control of the disease.

Ruth’s many leadership roles included being the Canterbury Clinical Lead for the Adolescent and Young Adult Cancer Service, a Board Member of the New Zealand Medical Association, and an elected member of the Canterbury DHB Clinical Board. She was Chair of the Canterbury Hospitals’ Medical Staff Association for 14 years and was on the Board of the New Zealand Medical Association. She retired from direct patient care for family reasons but remains active in the Australasian Leukaemia and Lymphoma Group of which she is a Life Member and has recently joined its CLL Working Party.

A patient with CLL set up  a Trust in Ruth’s name  for research in the South Island which helped fund the setting up of the Haematology Trials Unit in Dunedin and some specific CLL research done by the Christchurch Haematology Research Group, amongst other projects.

IQVIA report: Access to Medicines 4 (AtoM 4)

This report investigated and compared the funding and availability of modern medicines in the public health systems within New Zealand and Australia during the period January 2011- June 2023.


The AtoM 4 report highlights that the substantial difference between Australia and New Zealand in the availability of publicly funded modern medicines found in the first, second and third AtoM reports continues despite both countries having extremely similar decision-making and procurement systems for the public funding of modern medicines.

Key messages from the AtoM 4 Report include:

  • Australia publicly funded 2.5 times more modern medicines than New Zealand between January 2011 - June 2023 (187 vs 69).
  • Even for the same medicines, Australia was almost twice as fast to fund them. It took over 2 years in New Zealand (491 days vs 772 days)
  • The registration and availability of modern medicines in New Zealand lags well behind Australia. 70% of the 131 medicines publicly funded in Australia, aren’t even registered in New Zealand.

Since publication of the last AtoM report, the gap between Australia and New Zealand has widened regarding publicly-funded modern medicines access.

To read the report, please view it here: Access_to_Medicines_Report_September_2023


MyLifeMatters campaign: find an event near you

MyLifeMatters is a collective of patient advocate organisations representing more than 1 million patients with cancers, rare disorders, diabetes, and other life limiting conditions calling for the New Zealand Government to tackle the issue of investment and timely access to new and breakthrough medicines for the people of New Zealand.

At the heart of this campaign lies a shared vision: a New Zealand where every Kiwi patient has the opportunity to lead a healthy life, unhindered by poor investment, and access to life-saving medicines that are available in other countries.

Through awareness, your advocacy, and courage, we aim to shape a brighter tomorrow for patients in Aotearoa.

Please find out how to take action here: My Life Matters Event Dates