The proposal is outlined by Pharmac, an organization responsible for managing the New Zealand Pharmaceutical Schedule, which outlines the medicines funded for use within the country's public health system. 

Trastuzumab is a monoclonal antibody that binds to and inactivates the human epidermal growth factor receptor 2 (HER2)/neu receptor. In some cancers, notably certain types of breast cancers, HER2 is over-expressed, and causes cancer cells to reproduce uncontrollably. Trastuzumab is therefore used to treat HER2 positive (HER2+) breast cancers [1].

Currently, in New Zealand, only the brand Herceptin is funded by Pharmac for intravenous trastuzumab treatment.

The proposal aims to widen access to intravenous trastuzumab by funding additional brands, namely Ogivri and Kanjinti. These brands are biosimilar medicines that have been shown to be equivalent to the reference brand, Herceptin, in terms of efficacy, safety and quality. By funding multiple brands, Pharmac aims to enhance competition, reduce costs and increase patient access to this important treatment.

Pharmac has conducted an economic analysis that suggests widening access to these additional brands could result in substantial cost savings, potentially allowing more patients to benefit from intravenous trastuzumab. The proposal also includes changing the funded brand from Herceptin to a biosimilar brand for all patients receiving funded trastuzumab. This change is intended to promote cost savings and align with Pharmac's commitment to achieving the best health outcomes for New Zealanders.

To support this proposal, Pharmac has engaged in a consultation process to gather feedback from healthcare professionals, patient advocacy groups and the public. They have sought input on various aspects, including the clinical benefits and risks of using multiple brands, the impact on patients and healthcare providers, and any potential barriers or challenges associated with the proposal. Pharmac has invited submissions and is actively encouraging stakeholder participation in shaping the final decision. 

Pharmac acknowledges the significance of the proposal and the potential impact it may have on patients and healthcare professionals. They assure that patient safety and clinical outcomes remain a priority throughout the decision-making process. The final decision on widening access to intravenous trastuzumab and changing the funded brand will be made by Pharmac's Board, taking into account all relevant feedback and evidence.

In conclusion, Pharmac's proposal aims to increase patient access, promote competition, and achieve cost savings. The consultation process allows stakeholders to provide feedback and contribute to the decision-making process. Pharmac is committed to ensuring patient safety and clinical efficacy while considering the diverse perspectives and interests involved. This is not the first time that Pharmac has taken such action, as in 2021, they funded adalimumab biosimilar Amgevita [2].

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References
1. GaBI Online - Generics and Biosimilars Initiative. Biosimilars of trastuzumab [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jul 28]. Available from:
www.gabionline.net/biosimilars/general/Biosimilars-of-trastuzumab
2. GaBI Online - Generics and Biosimilars Initiative. New Zealand announces funding for adalimumab biosimilar [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jul 28]. Available from:
www.gabionline.net/biosimilars/news/new-zealand-announces-funding-for-adalimumab-biosimilar

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