Q1 Are there any targeted therapies or immunotherapies for my cancer?
Q2 Are these available to me in Australia?
Q3 Are these cancer therapies available on the Pharmaceutical Benefits Scheme or do I have to pay the full cost?
Why are some therapies not offered to patients in Australia?
- Some therapies are available overseas but not in Australia. This is because the therapies haven’t had approval from the Therapeutic Goods Administration (TGA) for use in Australia.
- Even if approved by the TGA, not all targeted therapies, immunotherapies and chemotherapies are available at a reduced cost on the PBS.
- Because the cost of these drugs can be very high, doctors may assume that the average person cannot afford them and may not discuss them.
- It’s important that patients have all the information they need to make decisions about their treatment, including whether or not therapies are available even if the costs are not covered on the PBS.
Why aren’t all cancer therapies on the PBS?
- Immunotherapies and targeted therapies are new and changing therapies. Most take many years (up to 12 years) and billions of dollars to bring to market. In Australia, these drugs must first be approved by the Therapeutic Goods Administration (TGA) before they can be considered for PBS approval.
- The Pharmaceutical Benefits Advisory Committee (PBAC) evaluates the costs, effectiveness and safety of therapies across a broad range of medical areas, one of which is cancer. There is a complex and lengthy process for approval of therapies to be on the PBS. The PBAC makes recommendations on which drugs should be approved. Outcomes of these meetings are available on their website https://pbac.pbs.gov.au.
- Therapies can be approved by the TGA for use in Australia but not necessarily gain approval for inclusion on the PBS. TGA approved drugs are able to be prescribed in Australia but require the patient to cover the full cost if they are not on the PBS. When a patient is unable to cover the cost, other options may be available and these are discussed below.
What happens when the therapy is not available on the PBS and the cost is high?
- Sometimes pharmaceutical companies make high cost drugs available on a special access scheme pending PBS approval. It is important to ask whether there are therapies relevant to your cancer available on this access scheme.
- A clinical trial may be available either locally, nationally or internationally and patients can ask their Oncologists whether there is an opportunity to participate in a trial. Costs of therapy are covered by the trial.
- Crowd funding provides opportunities to raise money for individuals who have difficulty with the costs of treatment. Rare Cancers Australia, for example, assists with donor support.
- It’s always worthwhile discussing with your Oncologist what options may be available to help with costs.
Please note that the information contained in this article is for educational purposes only. It is important that you seek medical advice from a medical practitioner or specialist (e.g., Oncologist) on the most appropriate treatment for your cancer.
If you are unsure of the therapies available for your cancer or what your treatment options are, I am available to discuss these with you.
Contact Dr Hawson for an appointment