New Zealand’s Blood Cancer Crisis: Why Patients and Doctors Are Leaving Home
Over 50 monthly doses of daratumumab. That’s how many a single Australian haematologist, Professor Judith Trotman, has administered to New Zealanders who’ve crossed the Tasman Sea seeking life-saving treatment. It’s a stark statistic that underscores a growing crisis: blood cancer care in Aotearoa is falling dangerously behind, forcing patients to become ‘medical migrants’ and driving highly skilled doctors to seek opportunities abroad.
The Daratumumab Disparity: A Decade Lost
Daratumumab, a targeted antibody therapy for multiple myeloma, is approved and funded in over 45 countries. In New Zealand, however, it remains on Pharmac’s “options for investment” list – a waiting list that, for many patients, is a death sentence. Professor Trotman, chair of the Australasian Leukaemia and Lymphoma Group, paints a grim picture. “It distresses me greatly that despite the unparalleled media and community focus…there’s still no funding for daratumumab.” The delay isn’t about cost, she explains, but a systemic failure to prioritize and invest in modern cancer treatments.
Jo Neep’s story is a heartbreaking example. Faced with a lack of access to daratumumab in New Zealand, she made the difficult decision to relocate to Australia. “I felt no choice but to move,” she told Checkpoint, highlighting the desperation driving patients to seek care elsewhere. This isn’t an isolated case; Professor Trotman believes many more are following suit, creating a silent exodus of New Zealanders seeking essential medical care.
Beyond Daratumumab: A Systemic Failure
The issue extends far beyond a single drug. Professor Trotman warns of a broader trend: New Zealand’s healthcare system is struggling to attract and retain top medical professionals. “So many New Zealand doctors…just can’t envisage returning because New Zealand is just so far behind in medicines access and access to the basic tools for a cancer specialist to practice.” This ‘brain drain’ is exacerbated by the “moral injury” experienced by doctors practicing in New Zealand, forced to deliver substandard care due to limited resources and outdated treatments.
Recent funding boosts, including a $604 million increase to Pharmac’s budget, have yielded some progress, with six new blood cancer medicines approved. However, as Professor Trotman points out, these are often “tinkering around the edges.” Many represent older therapies, like bendamustine for chronic lymphocytic leukaemia, when targeted enzyme inhibitors offer superior outcomes and improved quality of life. The piecemeal approach, she argues, is “no longer fit for purpose” and fails to optimize treatment strategies for individual patients.
The Rise of Medical Migration and its Consequences
The consequences of this disparity are far-reaching. Medical migration not only places a burden on Australia’s healthcare system but also depletes New Zealand of its skilled workforce. Attracting doctors back becomes increasingly difficult when they face the prospect of practicing “bare hands medicine” – lacking the tools and treatments readily available elsewhere. This creates a vicious cycle, further exacerbating the crisis and jeopardizing the future of blood cancer care in Aotearoa.
Looking Ahead: Personalized Medicine and the Need for Urgent Investment
The future of cancer treatment lies in personalized medicine – tailoring therapies to the unique genetic and molecular characteristics of each patient. This requires access to advanced diagnostics, innovative drugs, and a healthcare system capable of rapidly adopting new technologies. New Zealand’s current approach, hampered by funding constraints and bureaucratic delays, is ill-equipped to meet these challenges.
A shift in strategy is urgently needed. Rather than incremental funding increases, a substantial and sustained investment in cancer medicines and infrastructure is essential. This includes streamlining the Pharmac approval process, prioritizing innovative therapies, and fostering collaboration between researchers, clinicians, and policymakers. Furthermore, addressing the concerns of New Zealand doctors and creating a supportive environment that encourages them to return and practice at the forefront of their field is paramount.
The situation demands a proactive and forward-thinking approach. Without significant change, New Zealand risks falling further behind, condemning patients to unnecessary suffering and perpetuating a cycle of medical migration. The health and wellbeing of New Zealanders depend on a commitment to providing access to the best possible blood cancer care, and that requires bold action now. What steps do you think New Zealand needs to take to address this critical healthcare gap? Share your thoughts in the comments below!
