A new blood cancer treatment described by scientists as acting like a "Trojan horse" inside cells is one step closer to reaching patients in New Zealand, but access could still be years away.
The medicine, belantamab mafodotin, has been approved by Medsafe and could benefit up to 2500 Kiwis living with multiple myeloma.
However, without public funding from Pharmac, many patients may remain unable to access it.
For Sue and Peter Roylance, humour has helped them navigate the challenges of a decade-long cancer journey.
“I’m the younger one… see I’m only 81,” Peter joked.
Sue was diagnosed with multiple myeloma 10 years ago and was able to join a clinical trial for the drug, something she said changed her outlook entirely.
“It has had quite an effect on my life because over time it has given me the confidence to feel that I have a bit more of a future,” she said.
How the treatment works
Belantamab mafodotin is given via infusion alongside other medicines. It works by entering cancer cells and destroying them from within, a mechanism likened to a “Trojan horse”.
Consultant haematologist Dr Rodger Tiedemann said the results seen in trials were significant.
“It can certainly extend patients’ lives and, compared to standard of care treatment in the clinical trials, it’s added about another two years of progression-free survival,” he said.
“With the standard treatment, patients had about a year of progression-free survival and about three years with this drug.”
Approval doesn’t guarantee access
Despite regulatory approval, Tiedemann warned that public access is far from guaranteed.
“From my experience with Pharmac funding, it often takes many years to see that translate into actual public access to the medicine,” he said.
“I’m really hopeful that this moves a lot faster than that, but I’ve yet to see that happen.”
New Zealand already lags behind comparable countries. Survival rates for multiple myeloma patients here are around 14 and a half months shorter than in Australia.
Tiedemann said the slow funding process was also discouraging pharmaceutical companies from entering the New Zealand market.
“We already see a number of companies failing to even register their medicines in New Zealand, let alone apply for funding,” he said.
“They look at New Zealand as a bit of a lost cause. They see that other people have drugs on the waiting list for seven, 10 years, going all the way to patent expiry.”
Government response
Associate Health Minister David Seymour said efforts were underway to improve access to new medicines.
“We’ve introduced the parallel assessment pathway, and Medsafe is granting medicines approvals faster every year,” he said in a statement.
“This will continue as the rule of two comes into force. Companies can now also advertise their latest innovations in health products and medicines at New Zealand medical conferences and trade shows.”
However, he emphasised that Pharmac independently decides which medicines receive funding.
A chronic condition with limited options
Multiple myeloma remains incurable, meaning patients often cycle through treatments as each one eventually stops working.
“There’s no single drug that will cure myeloma. It’s not curable,” Sue Roylance said.
“Patients can take a drug for a period of time and then discover it is no longer working. They then have to switch to another drug or combination of drugs.”
For Nichola Oakenfull, who was diagnosed at 41, the delay in funding was deeply frustrating.
“Imagine literally saying to any other person with any other chronic illness, ‘we are just going to stop giving you medicine now’,” she said.
“That’s essentially what is happening with myeloma patients.”
For many New Zealanders living with the disease, the hope is that approval will soon translate into real access.
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