Clinton’s life could be cut short unless he pays thousands for PBS-listed medication
For a 42-year-old father of three, a promising treatment for a rare and aggressive cancer is slipping out of reach due to limitations in pharmaceutical coverage. Clinton, diagnosed a decade ago, experienced a remarkable response to selpercatinib, a medication that specialists described as exceeding expectations.
A Rare Cancer, A Promising Treatment
Clinton’s health journey began with an urgent doctor’s appointment, leading to a diagnosis of medullary thyroid carcinoma, a rare form of thyroid cancer. While surgery initially addressed much of the tumor, it continued to spread. Eighteen months ago, selpercatinib offered a significant improvement.
Initially, Clinton received selpercatinib through Eli Lilly on a compassionate basis while awaiting assessment for inclusion on the Pharmaceutical Benefits Scheme (PBS). However, despite being listed on the PBS, coverage is currently limited to patients with lung cancer.
Financial Strain and Rationing
Late last year, Clinton received notification that Eli Lilly was withdrawing the compassionate supply of the medication. The cost of selpercatinib, should he continue treatment independently, is $8,000 per month – a sum Clinton and his wife, Sally, cannot afford. They are parents to Chris, 14, Shayla, 11, and Thomas, 2.
Professor Bruce Robinson, an endocrinologist, treats multiple patients awaiting PBS coverage for this drug. He stated that discontinuing selpercatinib “would be disastrous,” potentially leading to rapid cancer regrowth and a fatal outcome.
Against medical advice, Clinton has begun rationing his remaining supply of selpercatinib. He expressed profound concern about the potential for a shortened life and the impact on his family.
Future Considerations
The Pharmaceutical Benefits Advisory Committee is scheduled to review the listing of selpercatinib for medullary thyroid cancer next month. However, the meeting has already been postponed once, and any resulting changes to PBS coverage would likely take months to implement. A request for intervention was made to Federal Health Minister Mark Butler, but received no response.
Eli Lilly characterized Clinton’s situation as indicative of systemic issues within the PBS. The company noted that selpercatinib is subsidized for medullary thyroid cancer in the UK since 2021.
Frequently Asked Questions
What type of cancer does Clinton have?
Clinton has a rare form of thyroid cancer called medullary thyroid carcinoma.
What is the cost of selpercatinib if Clinton has to pay out-of-pocket?
The cost of selpercatinib is $8,000 per month.
Is selpercatinib currently covered by the PBS for Clinton’s condition?
Technically, selpercatinib is on the PBS, but only for lung cancer patients.
What factors influence access to life-saving medications beyond medical need?