Blue Jackie: Estimates Debate — In Committee 
Blue Jackie: Estimates Debate — In Committee 
[Volume:640;Page:10434] 
Dr JACKIE BLUE (National) 
: 
 I am pleased that the Minister is here tonight and I hope he does take a call. I want to talk about Herceptin. It was mentioned in the Budget that money has been allocated for an international trial. I asked the Minister questions prior to our meeting in the Health Committee and I asked additional questions on the day and quite frankly I was really concerned and perturbed by the answers. 
My first concern—I have a number of them—is the proposed trail for which $5 million has been allocated. I might add here that whenever the international trial is mentioned by the Minister he always qualifies it with an adjective such as “possible” “proposed” or “potential”. There is no date and there is no certainty. It is floated as something in the future. There is no guarantee that this trial will get off the ground and indeed if it does get off the ground whether sufficient numbers of women will be recruited into it so that the results will be statistically significant. 
So we have a situation whereby from 1 July women have been eligible for the 9-week regime. Let us look at this 9-week regime that is now on offer. It is based on a very small trial in Finland—the FinHer trial. Only 250 women participated and of those 250 only 52 had the 9-week regime that is now on offer in New Zealand. Because the numbers were so small the results were not statistically significant. Even the Minister admits this. He told the Health Committee that the FinHer study was underpowered—which means there were not enough women—and that there were quite large “error bars”. When there are large error bars it means that there is uncertainty around the results. I ask the Minister why when he believes the 9-week Herceptin results are so uncertain he is now offering the 9-week regime to New Zealand women. Perhaps the Minister will take a call to explain that. What does it say about this Government and what it thinks about New Zealand women? But that is not all—there are more concerns. 
I asked the Minister what reports he has received from oncology groups about the 9-week combination regime and I asked what that advice was. I was provided with a summary of the advice and I looked really really hard but I could not find any comments supporting a 9-week treatment. Here are some of the comments: “9-week data is too weak”; “9 weeks is speculative”; “a 9-week proposal is out of line with best-quality evidence provided”; “the weight of evidence supports 12 months”; and “data from FinHer is not weighty evidence on which to base serious funding decisions”. What have we got? We have a 9-week trial have we not? Yet that is what our New Zealand oncologists told our Minister the very same Minister who had told Parliament a few months before that he would take on the views of the oncology community. And what has he done? He has done the exact opposite. What does this say about our Minister of Health? 
Without a clinical trial that can recruit sufficient numbers it may be years and years before we know whether the 9-week regime is a dud. From 1 July women are basically flying blind. They are not part of a clinical trial. No data is being collected. They are not being monitored as if they were in a clinical trial. There is no analysis of whether the 9 weeks is effective. The only data that is being collected is the very basic data of the Cancer Registry which collects only registrations and deaths. It does not record what happens in between. There is no record if a woman develops a relapse. What is more our data is hopelessly out of date. The latest data is confirmed to be from 2002—that is over 5 years ago. It is far too out of date. 
For the sake of argument let us say that the trial does get off the ground. Women will have no option but to enter it because that is the only way they will get a fifty-fifty chance to get the international standard of care which is 12 months. It will be a roll of a dice will it not? Will Lady Luck look after these women? I have spoken to two women who have actually started the 9-week regime. They have both told me that once they have completed it they will self-fund to complete 12 months of Herceptin. It is my prediction that that is what will happen if we get this trial up and running. Some of the unlucky ones who get the 9-week trial will find the money to self-fund to complete a 12-month course. What will that do? It will contaminate the results. It will make an absolute joke of the trial. 
What has happened is a total and absolute cop-out by this Government. Women are being dished up an unproven 9-week Herceptin regime. Out of 23 OECD countries we are the only country that has made this decision. We have to point to Pharmac and its decision-making process. I applaud those eight courageous women who have lodged a judicial review over the decision for a 9-week regime. Let the truth be revealed.