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Bid to Cut Cancer Drug Cost Rejected in Australia

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Prime Minister John Howard has refused to support a push by asbestos disease sufferers to subsidise the only drug available to treat mesothelioma.

Mr Howard has instead told the Asbestos Diseases Foundation that mesothelioma sufferers should go to their state governments for help to buy the drug, which costs $20,000 per treatment cycle.

About 600 Australians are diagnosed every year with mesothelioma, a fatal cancer caused by exposure to asbestos.

Health Minister Tony Abbott also tried to shift blame onto the states, saying that state governments had an obligation to treat patients in public hospitals free of charge.

Mr Abbott has consistently refused to support the push to have the drug, Alimta, listed on the Pharmaceutical Benefits Scheme schedule.

Mr Abbott refused to speak to The Sunday Age but through a spokeswoman said that Alimta had not been listed on the PBS because "the Pharmaceutical Benefits Advisory Committee — an independent, expert committee — rejected the submission on the basis of unacceptable cost-effectiveness and uncertainty about whether there is any increased quality of life associated with any survival gain".

Alimta, which is manufactured by pharmaceutical giant Eli Lilly, has been knocked back three times by PBAC over the past three years. It is due for consideration again in November.

It would cost taxpayers between $5 million and $7 million a year to subsidise the drug. Last week, the 2006-07 budget surplus was revised upwards to more than $17 billion.

Alimta does not cure mesothelioma, but can extend a patient's life for several years and reduce pain and suffering.

Asbestos Diseases Foundation president Barry Robson urged the Government to support the push to have the drug listed on the PBS.

"Alimta makes for a softer landing for meso sufferers," Mr Robson said. "Not only does it extend life, but it improves the quality of life.

"So, for people who can't afford it, it's just tragic, and also for the doctors who want to use it but can't prescribe when they know patients can't afford it."

Alimta is subsidised for the treatment of mesothelioma in most other OECD countries, such as France, Germany, Sweden, Japan and Britain.

Last week, Mr Robson received a letter from a senior adviser to Mr Howard, Perry Sperling, which said Mr Howard could not interfere with the deliberations of PBAC and urged mesothelioma sufferers to put pressure on state governments to provide assistance through the state hospital systems.

In NSW and Western Australia, government subsidy schemes are in place to help mesothelioma sufferers gain access to Alimta, but Victoria, South Australia, Queensland and Tasmania provide no government assistance.

The executive director of the Asbestos Diseases Society of Victoria, Leigh Hubbard, said the inequities were outrageous.

"If the PBAC submission in November is unsuccessful, we will hound whoever wins the federal election until they do the right thing," Mr Hubbard said.

"The Government has acted unilaterally on other vaccines and drugs and we expect them to support people in need — victims who in some cases are cancelling treatment or whose doctor won't even suggest Alimta because they know they can't pay for it."

The Asbestos Diseases Foundation has joined forces with Eli Lilly in a bid to get the drug listed on the PBS. Eli Lilly spokeswoman Rikki Jones said the company disagreed with PBAC's view that Alimta was not a cost-effective medicine for mesothelioma treatment.

"It is important to note the price offered to the PBAC in the last two submissions is among the lowest of any country within the Organisation for Economic Co-operation and Development," Ms Jones said.

The latest submission included additional data from clinical programs showing that Alimta's toxicity was "mild and manageable for most patients", she said.

Senior pharmaceutical industry sources remain bitter over the conduct of a senior adviser to Mr Abbott, Isobel Brown, who has been accused of trying to bully pharmaceutical manufacturers into not making their PBAC applications public.

Industry sources say Ms Brown has been instrumental in ensuring that Alimta was rejected by PBAC. Mr Abbott said through a spokeswoman that he had confidence in Ms Brown.

Asked if Mr Abbott was aware that Ms Brown was alleged to have threatened Eli Lilly if it tried to raise public awareness regarding Alimta, Mr Abbott's spokeswoman said: "It is important for companies to respect the processes for drug approvals for PBS listing. Ms Brown would have been doing her job in pointing that out."

Federal Labor health spokeswoman Nicola Roxon backed the push to have the drug listed on the PBS.

"We're talking about brave Australians who have suffered a lot, and obviously government should be doing all it can to help them," she said.

"Labor would ask PBAC to reconsider its decision to reject the listing of Alimta."

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