Hundreds of patients with multiple sclerosis are set to receive faster access to new drugs that work better than their current ones.
The new drugs are part of major proposals just released by the drug-buying agency, Pharmac, for public consultation.
The proposals cover provisional agreements between Pharmac and drug companies Novartis and Biogen. They cover 19 medicines, 10 of them never before funded.
New treatments for multiple sclerosis (MS) are a focus, with Pharmac labelling these planned changes the most significant in 15 years.
About 600 New Zealanders get treatment funded for a type known as relapsing-remitting MS.
Until now patients have only been able to get access to three funded treatments: two beta interferon drugs and glatiramer.
Access has been restricted, so to get beta interfon they have had to have a particular disability score, and a certain number of relapses a year.
Patients have to go off the medicine again if their score goes above a certain level, causing dissatisfaction about what Pharmac conceded was a very limited arrangement.
Multiple Sclerosis Society spokesperson Neil Woodhams said access to current drugs was unduly restrictive, and people had moved to Australia and other countries to find a way round the system.
"Just recently there was Tim Bateman, the Hurricanes player, (who) took his wife to Japan so he could get access to (the drugs)," he said.
Risks and benefits
Pharmac is proposing to fund two new treatments, natalizumab from Biogen (trade name Tysabri), an infusion given in hospital, and the tablet fingolimod from Novartis (Gilenya).
Natalizumab is associated with an increased risk of viral infection of the brain. Consultation papers released by Pharmac said there was a very low chance of getting this, but for patients who did, it could be very serious involving death or severe disability
Pharmac chief executive Steffan Crausaz said that, if approved, risks and benefits of that treatment would need to be carefully weighed between each patient and their specialist neurologist.
But he said the proposed new MS treatments were considerably more effective than the current treatments, and understood to reduce relapses by 60 percent to 70 percent.
Most people with this type of MS are expected to go onto the new drugs, and could begin after diagnosis, rather than having to wait for a deterioration of their condition. Existing treatments would continue for those who couldn't tolerate the new ones.
But, if a patient on one of the new drugs did not show signs of benefitting, they wouldn't remain on the treatment.
Potential 400 new patients
Pharmac said it expected 400 new patients to move to the new MS treatments over the next five years if they're approved, following consultation.
Also part of the proposed multi-product agreements were new medicines for severe allergic asthma; the respiratory condition chronic obstructive pulmonary disorder; chronic myeloid leukaemia; Alzheimer's disease, and to treat a type of brain tumour that mainly affects children and where surgery was the only option currently.
Pharmac said one of the two agreements, with Novartis, involved the most medicines Pharmac has ever listed in one agreement with a drug firm, 17.
It said negotiating the complex agreements had taken six months, but if approved they would benefit 11,000 people over five years.
Public consultation closes on 29 August, with the Pharmac board expected to make a final decision in late September or October.