Depressed woman suffering from cancer
Depressed woman suffering from cancer

‘Shock’ after chemo test refused Medicare subsidy

Exclusive: A $5000 test that can indicate whether a breast cancer patient needs chemotherapy has been rejected for a government subsidy even though it would mean thousands of women could avoid harrowing cancer treatment.

The government's Medical Services Advisory Committee (MSAC) said there is not enough evidence to support a Medicare rebate for the test.

But breast cancer support groups are furious with the decision.

And US breast cancer expert Dr Eric Winer, from the Dama Faber Institute in Boston, said he was "shocked" by the MSAC decision.

In the US, all insurers paid for the genetic test for women with HER2 positive breast cancer when the cancer had not spread to the patients lymph nodes, he said

"I think it's a mistake," he said.

"To put it simply for a sizeable group of patients the decision tools you have will continue to be from the year 2000 instead of taking advantage of new tools for treatment decision."

A new test can help predict the risk that a woman’s breast cancer may recur. But it is not being added to Medicare.
A new test can help predict the risk that a woman’s breast cancer may recur. But it is not being added to Medicare.

The Oncotype DX test analyses 21 genes from a breast tumour and can help predict the risk that a woman's breast cancer may recur and the likely benefit chemotherapy may have in reducing that risk.

Specialised Therapeutics, the company which runs the test, claims an Oncotype DX score of 25 or less means chemotherapy is not necessary whereas a score of 26 or higher means chemotherapy would be beneficial.

The test is performed in a single laboratory in the US and has not been approved for use by regulatory authorities such as the US Food and Drug Administration nor by the Australian Therapeutic Goods Administration.

A clinical trial of 10,273 women with breast cancer found nine years after diagnosis the rate of disease-free survival was similar for women with a mid range score in the gene test.

Disease-free survival for those who received hormone therapy only was 83 per cent compared with women who received both hormone therapy and chemotherapy (84.3 per cent).

Specialised Therapeutics Australia Pty Ltd had applied for public funding of the Oncotype DX test in Australia but MSAC rejected the application on Thursday night.

"MSAC advised the Minister for Health that the evidence presented for Oncotype DX did not give the Committee confidence that the test would identify those patients who could safely avoid chemotherapy or those patients who would benefit from adding chemotherapy," it said in its report.

Yachting enthusiast Kari Svensen wishes the test was available to all Australian women after taking it. Picture: Supplied
Yachting enthusiast Kari Svensen wishes the test was available to all Australian women after taking it. Picture: Supplied

A spokeswoman for Breast Cancer Network Australia (BCNA) said they we disappointed the test had been rejected.

"We urge the companies supplying these tumour profiling tests to get together with the Government to find a way forward," BCNA CEO, Kirsten Pilatti said.

"If we can identify those people who will benefit from not having chemotherapy, it is essential that we save them from over treatment."

Chemotherapy has significant impact on a patient's life in treatment and well after someone's treatment has finished.

From the loss of work to long-term cognitive side effects, the impacts are significant, she said.

"Without a Medicare rebate, the Oncotype DX test will cost Australians up to $5000, which we know is out of reach for many," she said.

"BCNA wants to see Australians have access to this important diagnostic tool."

Yachting enthusiast Kari Svensen was one of the lucky women able to afford the genetic test when she was diagnosed with breast cancer over five years ago.

The 73-year-old from St Ives in New South Wales said the test found she didn't need to have chemotherapy to treat her cancer even though there were multiple Stage 2 tumours.

Instead she received 30 doses of radiation treatment.

Five years on she is still cancer free.

Ms Svensen said she was lucky her ex-husband Adelaide radio star Jeremy Cordeaux provided the funding for her to have the test.

"I cannot stress more emphatically the fact that I avoided chemotherapy and fervently wish this test was available to all Australian women, it should be in this country," she said.


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