BCNA News 28 Aug 2018
New capped access program for palbociclib
Pharmaceutical company Pfizer has advised BCNA about a new access program it will offer for the CDK inhibitor palbociclib (Ibrance) for people with metastatic breast cancer. The program will open on 1 October 2018.
The program will help people to access palbociclib for first-line treatment (for those newly diagnosed) and second- and later-line treatment (for those who have already been treated with a hormone therapy such as tamoxifen or an aromatase inhibitor for metastatic breast cancer).
Is there a cost for this program?
Yes. Pfizer has advised that people will have to purchase the first eight packs of palbociclib, at a cost of $4,850 per pack plus any script fees your pharmacist may charge. This means that you will have to pay around $40,000 before being eligible for free access. Once you have paid for eight packs, Pfizer will provide palbociclib free of charge for as long as you are clinically benefitting from it.
BCNA knows that $40,000 is too expensive for many people to be able to afford. We have communicated this concern to Pfizer who has advised it will still consider compassionate access (i.e. providing palbociclib free of charge) on a case-by-case basis. This request needs to be made to Pfizer by your medical oncologist.
What does this mean if I have already been paying for palbociclib for more than eight months?
BCNA is very pleased that Pfizer has responded to our request to help those women who have already paid more than $40,000 for palbociclib.
Anyone who can prove that they have already purchased eight packs in Australia will be eligible for the capped access program. Although the official program does not open until 1 October, anyone already paying whose doctor applies to Pfizer will be moved onto the free access program and will not have to wait until 1 October.
What if I have purchased palbociclib from overseas?
It may still be possible to move across to the capped access program if you have purchased eight packs from overseas. Talk with your medical oncologist about whether he/she can apply to Pfizer for you.
What if I am also recommended to have the drug fulvestrant (Faslodex)?
People who are recommended to have a CDK inhibitor as a second-line therapy may also be prescribed the drug fulvestrant. Although this drug, given as a monthly injection, is not on the PBS, there is a patient access scheme through the drug company AstraZeneca. Under the scheme, patients pay for injections two, three and four, with the first (a loading dose) and fifth and later doses provided free of charge by AstraZeneca. The three injections you pay for will cost you about $3,600 in total.
Your medical oncologist will need to enrol you in the Faslodex program from the first dose. If you have private health insurance or Veterans' health vover, your oncologist could apply to them to fund the next three doses.
How else can I access a CDK inhibitor?
If you are newly diagnosed with metastatic breast cancer, the CDK inhibitor ribociclib is available as a first-line treatment through the PBS for the cost of a PBS script fee - $39.50 or $6.40 concession.
Where can I get more information?
Your medical oncologist is the best person to talk to if you have any questions around the capped access scheme for palbociclib.
If you are living with metastatic breast cancer and need information or support, call our Helpline on 1800 500 258.
Image via ABC News.