Medicines New Zealand says Aotearoa is at the bottom of the OECD in terms of both access to modern medicines and overall medicines investment levels. Photo: RNZ
A specialist is concerned sick New Zealanders are missing out on clinical drug trials, due to Aotearoa falling behind with funding modern medicine.
A 2022-23 Medicines New Zealand report has revealed the country is on average, twice as slow to publicly fund modern medicines, compared with other countries.
The majority of trials require participants to have access to what is known as "standard of care drugs" or the best available medicine, to provide a comparison to the trial drug.
Aotearoa behind in funding modern medicines - specialists
Haematologist Dr Rodger Tiedemann told Checkpoint the primary reason for New Zealand being unattractive for these trials was that there were not patients who were eligible.
"Most new drugs are tested in patients who've gone on and failed standard of care treatments or they're tested against those standard of care treatments as a comparator arm and when New Zealand doesn't even offer those standard of care treatments to our patients, we don't really have a pool of eligible patients to go on clinical trials - and so clinical companies start looking elsewhere to test their medicines," he said.
"This is a real devastating loss for New Zealand patients because some of these trials offer the most advanced and active treatments that are available to them."
It was primarily cancer patients who were missing out, he said.
There were a lot of clinical trials for cancer patients, particularly those with incurable cancers, he said.
On being asked how often he was aware of a clinical trial that went elsewhere because New Zealand patients were not eligible to participate, Tiedemann said this morning he was attempting to get a clinical trial for some patients and speaking to a drug company that had trials in Australia, but ended up being turned down because patients in New Zealand were ineligible since they did not have access to an existing medication.
"This is a common finding, you know I'm really looking for trials for our relapsed patients because we just don't have enough standard of care treatments to offer them but again we run up to this barrier that we don't have the standard of care treatments here, so they're not eligible."
New Zealand only spends about a third of what other countries of comparable size and wealth do on medicines, he said.
"It makes no sense because ... Australia's done studies that show a 60 to one return on investment in clinical trials largely due to improved patient outcomes and reduced health care assistant costs - so there's actually a lot of financial benefit to being involved in studies like this."
Even if New Zealand patients were prepared to fund the standard of care drugs themselves they would be unlikely to qualify for a clinical trial, he said.
"Simply because the number of patients who do that is so small and it's an unreliable number of patients to open a clinical trial for. You know there's a lot of financial and regulatory things to go through, hurdles to jump through to get a trial up and running and if you're relying on a few private payer patients often the drug company won't look at that as a secure population that they're going to be able to enrol in their trial."
Tiedemann said ideally New Zealand patients should have access to standard of care drugs to allow them to take part in these trials.