New Zealand cancer patients should have access to erythropoietin treatment.
Erythropoietin was the first haematopoietic growth factor to be cloned and put to clinical use in patients with anaemia. In New Zealand, the agent is approved and funded for patients with anaemia secondary to renal failure. Although there is Medsafe approval for its use in various other conditions, including cancer patients, it is not funded by Pharmac for these conditions. There is good evidence that erythropoietin will induce meaningful increases in haemoglobin levels in approximately 60% of cancer patients. Non-responders can be identified within 2-4 weeks of starting therapy and the drug discontinued, thus improving the cost-effectiveness of the programme. Responders have a significant reduction in blood transfusions, have an improved quality of life, and possibly have a better tumour response to chemo-radiotherapy, thus resulting in longer survival. British and American guidelines advocate a significantly greater use of erythropoietin than the very restrictive New Zealand use. Pharmac should review the current evidence as to the benefits of increased erythropoietin usage in New Zealand, and endorse increased access to this agent.
Carter
John
J
Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. vanness@orcon.net.nz
Clay
Jennifer
J
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology*; D003362:Cost-Benefit Analysis; D004335:Drug and Narcotic Control; D004921:Erythropoietin / Q000191:economics / Q000627:therapeutic use*; D019317:Evidence-Based Medicine / Q000379:methods; D006297:Health Services Accessibility; D006801:Humans; D009313:National Health Programs / Q000191:economics; D009369:Neoplasms / Q000150:complications*; D009520:New Zealand; D016896:Treatment Outcome
D004921:Erythropoietin