Earlier this year, Ibrance (palbociclib) was added to the Pharmaceutical Benefits Scheme (PBS) for people newly diagnosed with metastatic hormone receptor positive breast cancer. This means two CDK inhibitors – Kisqali (ribociclib) and Ibrance – are now listed on the PBS for first-line treatment of metastatic disease. It is hoped a third drug, Verzenio (abemaciclib), will be added to the PBS later this year or in early 2020. It will also be for first-line treatment only.
BCNA regularly hears from people wanting to use one of these drugs as a second- or later-line treatment (i.e. after the cancer progresses on another treatment). We understand the stress and anxiety that can result when you think there is a new treatment that might help you, but you can’t get your hands on it.
The reasons why none of the CDK inhibitors is currently on the PBS for later-line treatment are complex. Unfortunately it is not simply a matter of the Australian Health Minister making a decision to add them to the PBS. There is a thorough process that needs to be followed to ensure all drugs put on the PBS are effective for the purpose for which they are listed and are cost-effective for Australian taxpayers, who fund the PBS. The Health Minister has, however, committed to adding all new drugs that go through the process and are recommended for listing.
To date, none of the three drug companies that produces these drugs has made an application to have them listed on the PBS for later-line treatment. BCNA is applying significant pressure to the companies, and other stakeholders including breast cancer clinicians, to try to overcome the barriers.
This situation is so frustrating for our members living with metastatic disease and we will not stop until we can change the inequity.
How can I access a CDK inhibitor for later line treatment now?
Currently the only way to access a CDK inhibitor in Australia for later-line treatment is by paying the full price (about $5,000 per month) or through a patient access program.
Pfizer is running an access program for for Ibrance. However, there is a hefty patient contribution which means most people are not able to afford it. Pfizer requires you to pay for the first eight packs of Ibrance, at a cost of $4,850 per pack plus any dispensing fees your pharmacist may charge. This means you will have to pay around $40,000 before being eligible for free Ibrance through the access scheme. Once you are eligible for free Ibrance, Pfizer will continue to provide it for as long as it is clinically benefiting you.