Photo: RNZ / Samuel Rillstone
Cabinet ministers are expected to decide on Monday whether to significantly boost Pharmac's funding to try to make right National's broken promise on cancer drugs.
RNZ understands ministers will canvass a range of proposals and figures with an announcement to be made soon after it is signed off.
At least one of those options is a major investment - hundreds of millions of dollars - into Pharmac to allow it to work through its wishlist.
The Post reported on Friday that at least $600 million over four years was on the table.
During last year's election campaign, National pledged to fund 13 specific cancer treatments, but the promised funding did not eventuate in last month's Budget.
After a backlash from patients, ministers said they were working on a solution and to expect an announcement "soon".
Ministers have publicly raised three possible options: directing Pharmac to fund the drugs, equipping a separate agency to fund them, or boosting Pharmac's funding.
The issue has been muddled by conflicting comments coming out of the coalition, mainly relating to Pharmac's independence. The drug-buying agency operates independently from the government to avoid politicising which treatments are funded.
Health Minister Shane Reti this week guaranteed that all 13 named drugs would be funded, as promised.
In contrast, the minister responsible for Pharmac, David Seymour, refused to make that commitment and told a select committee he was "wholly committed" to Pharmac's neutrality.
A boost in Pharmac's funding, as is being considered, would avoid breaching that independence, but it would also not guarantee which treatments would be funded.
Pharmac's drug funding wish list includes more than 140 treatments but its order-of-preference is kept secret.
In a statement, a spokesperson for the prime minister stressed no decision had been made, but said the government had been clear about its commitment to improving access to cancer treatments.
"National campaigned on adding 13 new treatments to narrow the gap between what is available for Kiwis and what can be accessed in Australia.
"As we have said, work is underway to fulfil that commitment and we hope to have more to say about that soon."
A host of cancer advocacy groups have called on the coalition to honour its promise, but cancer experts have also criticised the list of 13 drugs as out-of-date.
Patient Voice Aotearoa spokesperson Malcolm Mulholland told RNZ he was in favour of an overall funding boost for Pharmac to allow it to work its way through its wishlist under all 13 drugs were delivered.
"This, in my eyes, is actually a real gamechanger when it comes to putting a serious dent in the waiting list that Pharmac has," Mulholland said. "It's just good news all round."
In a statement, Breast Cancer Foundation chief executive Ah-Leen Rayner said the news had given breast cancer patients hope as they were not included on initial list of 13 treatments.
"There are two treatments for incurable breast cancer on Pharmac's Options for Investment list - Keytruda and Enhertu - that are proven to give women more time and it's critical these are both given a high priority so Kiwis can access them urgently."