New Zealand's pharmaceutical management agency Pharmac has announced a proposal to significantly expand access to advanced melanoma treatments, providing a lifeline for patients with stage 3B to stage 4 disease beginning June 1, 2025.
The decision will fund pembrolizumab (Keytruda) for stage 3B or more advanced melanoma that can be removed surgically, as well as the combination of dabrafenib (Tafinlar) and trametinib (Mekinist) for BRAF-mutated melanoma that is either stage 3B or more advanced and surgically resectable, or has metastasized and become unresectable.
"This funding is long overdue, and we are delighted about the difference this will make for patients," said Andrea Newland, Chief Executive of Melanoma New Zealand, which has been advocating for increased treatment access and providing technical expertise to Pharmac.
Clinical Impact and Treatment Options
The expanded funding creates multiple new treatment pathways for advanced melanoma patients. For the first time, patients with stage 3B-D melanoma who previously had to self-fund or rely on insurance for immunotherapy will have access to funded Keytruda. Additionally, the immunotherapy can now be offered both neoadjuvantly (before surgery) to help shrink tumors and adjuvantly (after surgery) to reduce recurrence risk.
For patients with BRAF-mutated melanoma, the combination of BRAF inhibitor dabrafenib and MEK inhibitor trametinib provides a targeted therapy option that was previously unavailable through public funding.
These changes align New Zealand's melanoma treatment landscape more closely with international standards of care, empowering oncologists with a broader range of treatment options to provide personalized care based on individual patient needs.
Patient Perspective
The financial burden of self-funding these expensive treatments has been overwhelming for many patients. Finlay Bergin, a 28-year-old Auckland resident diagnosed with stage 3 melanoma in September 2024, has been paying for dabrafenib and trametinib through personal savings, family support, and crowdfunding.
"This [funded treatment] will make a huge difference and put me at ease, because the biggest stress since my diagnosis has been money related," Bergin stated.
New Zealand's Melanoma Burden
New Zealand has one of the world's highest rates of melanoma, yet patients have historically had less access to funded treatment options compared to many other countries, including neighboring Australia. The expanded funding represents a significant step toward addressing this disparity.
Melanoma New Zealand acknowledges that while this decision marks substantial progress, there remain patients who may not be eligible for these treatments or for whom the funding comes too late. The organization has committed to continuing advocacy efforts for further improvements in melanoma care.
Treatment Specifics
The funded treatments include:
- Pembrolizumab (Keytruda): An immune checkpoint inhibitor that helps the immune system recognize and attack cancer cells
- Dabrafenib (Tafinlar): A BRAF inhibitor that targets melanomas with specific BRAF gene mutations
- Trametinib (Mekinist): A MEK inhibitor that works synergistically with BRAF inhibitors to block different parts of the same signaling pathway
These medications have demonstrated significant efficacy in clinical trials, improving both progression-free and overall survival rates for advanced melanoma patients.
The full details of the funding announcement are available on Pharmac's website, with implementation set to begin June 1, 2025.
