What a new report about funding of cancer medicines tells us about the broader chronic underfunding of medications in NZ.
On 28 April 2022, the Cancer Control Agency I Te Aho o te Kahu, released a report that examined the gap between the number of cancer medications that Australia funds, versus how many are funded in New Zealand.
The report, Understanding the Gap: an analysis of the availability of cancer medicines in Aotearoa, has divided opinions, with some cancer advocacy groups saying that New Zealand should be funding many more cancer medications than the 18 identified.
But one area that isn’t being debated, and is a top frustration of Migraine Foundation Aotearoa New Zealand, is that the funding of new medications by Pharmac is in crisis in our country.
There are many organisations and advocates working to highlight unfunded medications in New Zealand. And we salute you. For people living in Aotearoa with migraine - and that’s at least 624,000 of us - the Government’s chronic underfunding of Pharmac for years is having a direct impact on our health.
Calcitonin gene-related peptide (CGRP) monoclonal antibodies are the first medications developed specifically to prevent migraine. Those with migraine may be familiar with the GGRP injectables Aimovig, Emgality, Ajovy and Vyepti.
In Australia, Emgality and Ajovy are funded on the PBS (similar to Pharmac funding) and Aimovig and Vyepti are available privately. In New Zealand, Aimovig is the only CGRP medication available, but at a cost of $678 for 70mg or $1,356 for 140mg. Often 140 mg is more effective. This cost is for one injection, and one injection is needed every month.
When medications like the CGRPs are considered for funding, what needs to be considered isn’t just what it costs to fund a medicine, but what the cost is of not funding it.
Migraine is most prevalent in women aged between 18–60 years. A time when women are working, raising families, contributing so much to society. Yet so many women with migraine are unable to work, or have to limit their career choices because of migraine.
Migraine isn’t fatal. But it causes the second highest rates of disability worldwide and in New Zealand it ranks just below low back pain and anxiety and has a similar disability impact to major depressive disorder.
But there are huge gaps in our knowledge about the prevalence of migraine in Aotearoa. Even less data on the cost that migraine has on society.
We must look across to our cousins in Australia for recent data. A publication released by Migraine and Headache Australia in 2018 found that the yearly cost of chronic migraine per person was AU$21,706; and AU$6,137 for episodic migraine. This included health system costs, such as paying to see health professionals and for medications, and productivity costs from the reduced ability to work and having to take time off work. If these estimates are similar for New Zealand, that would equate to around NZ$5 billion a year.
Sit with that for a moment. Five billion dollars a year. Imagine the impact spending $5 billion dollars on preventive migraine treatment could have for people in New Zealand.
When are we going to start investing in people’s health, and stop being the ambulance at the bottom of the cliff?
Migraine Foundation Aotearoa New Zealand was founded to tackle issues like these. Our voices need to be heard, and we need better access to and funding of medications that will improve our health, to benefit individuals and our wider society.
Pharmac declines application for a wider range of triptans in New Zealand