Prolonged discussions to determine the cost and ‘value’ of cancer medications are happening at the expense of Australian lives.
In a candid conversation as part of the Rare Cancers Australia Thought Leader Series, Chief Executive Richard Vines and Head of Cancer Research at Monash University Professor John Zalcberg discussed the practical and ethical implications of delaying access to urgent treatment for Australians living with rare cancer.
Professor Zalcberg emphasised the time-sensitivity of a rare cancer diagnosis.
“You don’t get a second chance at life. Nobody does. And if you’ve got a serious, life-threatening illness, then I think you’re entitled to receive the best. And I think our society expects that and I don’t think they always get it. If you’ve got a diagnosis of a serious cancer, you may or may not be alive in a year’s time to access treatment; there’s no waiting opportunity.”
“From my perspective, the principle needs to be, initially, access to the best available treatments. And that’s based on safety and efficacy, it’s not based on cost. There is a cost discussion, but it should occur after the fact.”
“As doctors we’re concerned with the person sitting in front of us; trying to deliver the best care, trying to give them the best chance at life, the best chance of a cure and reducing their suffering. What do we tell these people? ‘I can’t give you this drug because society can’t afford it in 20 years?’
“My view is that we’ve got to strive to do the best we can for the patients that are in front of us. We must try and improve life and opportunities for patients right now. I’m not saying we can do this in an environment where you don’t consider cost at all, but I think there is enormous room for improvement. We have a responsibility to the people in front of us to do better.”
“There are countries around the world where the issues around cost are important, but they’re not paramount. The sense we get here [in Australia] is that cost to the community is as important, if not more important, than the actual provision of the drug in the first place.”
“There are countries, for example, which will provide the drug at whatever the market price is, and then say we’ve got a year or two to work out the costs and we’ll do that afterwards. But in the meantime, people access the drug. There are various ways you can do that in a controlled manner in Australia. You could do it through a clinical trial network or through a registry process for example.”
“At the end of the day, what’s critical is that access is provided whilst the health economists and the government and the industry sponsor and patients and clinicians work out what’s a fair value for that benefit. But not let’s not argue about it while patients are dying, because that’s what’s happening.”
The RCA Thought Leader Series episode featuring Professor John Zalcberg is now available.