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CDK Inhibitors

BCNA News 11 May 2018

BCNA has welcomed the 2018 Federal Budget announcements of funding for ribociclb (Kisqali) to be added to the Pharmaceutical Benefits Scheme (PBS), 3-D mammography for women at risk of breast cancer, and investment in rural health, medical research and other health initiatives that will assist Australians affected by breast cancer.

Ribociclb (Kisqali) to be added to the Pharmaceutical Benefits Scheme (PBS)

BCNA is delighted by the Government’s announcement that ribociclb (Kisqali) will be listed on the PBS from 1 July 2018 for women newly diagnosed with hormone-positive, HER2-negative metastatic breast cancer. This means that no woman newly diagnosed with hormone-positive, HER2-negative metastatic breast cancer will hear the words, “your breast cancer has spread”, followed by, “treatment may cost you up to $5,000 per month”.

While this listing of ribociclib on the PBS is only for women newly diagnosed with hormone-positive, HER-negative metastatic breast cancer, this is a critical first step to getting ribociclb (or one of the other CDK inhibitors) listed on the PBS for use as a later line treatment. It also allows us to put more pressure on the drug companies to extend their compassionate access schemes to women as a later line therapy.

3-D mammography

Three-dimensional mammography for women at risk of breast cancer will be added to the Medicare Benefits Schedule (MBS) from 1 November 2018, allowing women to receive a Medicare rebate for this screening. 3-D mammography (also called digital breast tomosynthesis, digital tomosynthesis or just tomosynthesis) creates a three-dimensional picture of the breast. Research has shown 3-D mammograms may be able to detect more cancers than regular mammography that takes a flat 2-D picture of the breast. The new Medicare item will ensure that women who may benefit from this technology can affordably access 3-D mammography.

Improving the health outcomes of rural Australians

The announcement of $550 million over 10 years for a Stronger Rural Health Strategy is good news for Australians living in a regional and rural area. Much of the funding is focused on increasing the number of doctors, nurses and allied health professionals in rural and regional areas. The Government has also announced $94 million for the establishment of the Murray-Darling medical schools network to support the training of medical students in rural areas, the creation of a ‘More Doctors for Rural Australia’ Program, the establishment of a new Junior Doctors Training program and a Workforce Incentives Program aimed at encouraging health professionals, including allied health professionals, to work in rural areas.

The Government has also announced that there will be an independent review into the nursing workforce. BCNA will look for opportunities to highlight the essential role of cancer nurses in the treatment and care of women affected by breast cancer and the need to address any shortages in rural and regional areas. We will also advocate for improved access to specialised breast care nurses and cancer care coordinators for people living with metastatic disease.

Hospital funding

The Federal Budget includes an increase of $30.2 billion in public hospital funding over 2020-2025, under a five-year Heads of Agreement between the Commonwealth and the States and Territories. Public hospital funding agreements between the Commonwealth and States and Territories are complex, but a $30.2 billion investment over five years is welcome news. BCNA will advocate ensuring this means reduced waiting times for women requiring breast reconstruction in the public service.

The Government has also announced $50 million of funding in 2018-2018 and $50 million of funding in 2020-21 for a Health Innovation Fund, aimed at supporting the better use of health data and preventative health.

Investment in the Pharmaceutical Benefits Scheme (PBS)

The Budget also includes the provision of $1 billion for the listing of future medicines on the PBS. This is good news for Australians affected by breast cancer. In recent years, medical research has improved our understanding of the biology of breast cancer. Instead of breast cancer being viewed as a single disease, we now understand that breast cancer is a group of distinct molecular subtypes. This has changed that way new medications are developed, as researchers are increasingly able to target treatments to the specific subtypes. The CDK inhibitors are a good example of this. While targeted treatments have been shown to be very effective in improving the outcomes of women affected by particular subtypes of breast cancer, the drugs are often expensive and may only benefit a small, specific group of Australians. This can make it harder to get all of the new drugs approved in a timely manner.

BCNA hopes the Government’s investment in the PBS will enable the process of reviewing and assessing new drugs to be increasingly responsive and flexible and result in faster approvals so people who need them can access them at an affordable price.

Investment in medical research

BCNA welcomes the Government’s significant announcements of investment in medical research and development. This includes $3.5 billion for the National Health and Medical Research Council (NHMRC) and $500 million for the Biomedical Translation Fund. The Budget also an investment of $10.7 million in 2017-18 for genomics research.

BCNA will be stepping up our advocacy efforts for funding for breast cancer genomic testing following the announcement. This includes tests such as Oncotype DX, MammaPrint or EndoPredict. These tests can help women diagnosed with low-risk breast cancer and their treatment team better understand whether chemotherapy is likely to be helpful to reduce their risk of recurrence.

Palliative care

The Budget provides for $32.8 million of funding over four years to improve palliative care services for Australians living in residential aged care services. This is a welcome investment in palliative care.

A well-funded palliative care system is essential in ensuring women living with metastatic breast cancer are able to access services to address physical symptoms and side effects of treatment, such as pain, as well as emotional, social and spiritual support.

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