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Professor Andrew Spencer
Australian blood cancer patients are being denied access to life-extending drugs and treatments because of long delays and excessive regulation by the Pharmaceutical Benefits Advisory Committee (PBAC), a parliamentary inquiry has been told.
Leading haematologist Professor Andrew Spencer said the registry of myeloma cases established some eight years ago showed “very poor” outcomes for myeloma patients in Australia and New Zealand compared with other developed countries.
In myeloma patients over 70, the median survival rate in Australia was 44 months, almost half the median of 60 to 70 months in other countries, he said, giving evidence at the inquiry into approval processes for new drugs and novel medical technologies in Australia.
“That gap is getting bigger and bigger and bigger. That is not because we’re not good clinicians and good nurses and good hospitals but boils down purely to access to therapeutics. I could send someone to Greece three years ago to get daratumumab that I couldn’t give to my patient in Melbourne … We consider ourselves to be a First World nation, but we have Second World nation access to drugs,” he said.
Professor Spencer said it was notable that daratumumab was the first new drug approved for myeloma in Australia in more than a decade.
“For the past 14 years, there were only two classes of drugs available to treat myeloma. Not only were they only two classes of drugs available but the PBAC would not allow us to combine those drugs—they could be used in isolation—which beggars belief scientifically, but that’s how it was.
“In that time frame, half a dozen other drugs have been approved in other First World countries with different mechanisms of action to treat myeloma but not in Australia.”
The new drug, indicated for relapsed myeloma in combination with another drug already in use, took five years after its initial presentation to be approved by PBAC. However, the permitted combination was “the cheapest combination, the most toxic combination”, he said.
“It seems to me that this approach from PBAC is being driven by accountants; it’s not being driven by people who are actually looking at the evidence and saying, ‘Well, what is the best option for these patients?’ Because that clearly is not what happens in Australia. The process … is adversarial and it’s unrealistic.”