Pembro drug to be made available to all women with cervical cancer

Decision ends inequity whereby access was restricted to CervicalCheck patients

Vicky  Phelan initially funded her own treatment with Pembro and then had it funded by the State.  Photograph: Tom Honan/The Irish Times
Vicky Phelan initially funded her own treatment with Pembro and then had it funded by the State. Photograph: Tom Honan/The Irish Times

All women with cervical cancer are to be given access to the immunotherapy drug Pembro provided their doctors recommend the treatment.

The decision ends an inequity that currently exists whereby the 221-plus women who have cervical cancer and were caught up in the CervicalCheck controversy have access to the drug but others with the disease do not.

Labour party health spokesman Alan Kelly said he had been informed by the Department of Health that the costs of Pembro (Pembrolizumab) for cervical cancer patients will be funded by the State where clinically recommended.

The drug is being made available "on an exceptional basis" for cervical cancer patients "on a case-by-case basis in public hospitals when a treating clinician determines that this is in the patient's best interests," a spokeswoman for Minister for Health Simon Harris confirmed.

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All prescribing decisions will be entirely a matter for the treating doctor, in lines with patient safety protocols and the Medical Council’s ethics guide, she said.

“This arrangement will apply to cervical cancer patients only. The statutory responsibility of the HSE for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013, remains unchanged.”

Mr Kelly said the announcement was “a long time coming” for women with cervical cancer. “We had a situation where women who were at the centre of the Cervical Check scandal were getting the Pembro treatment for free but other women with cervical cancer were paying unaffordable amounts for this treatment.

"Working with women like Vicky Phelan, Áine Morgan and Tracey Brennan I brought the inequity of the provision of Pembro to the Minister's attention. I'm glad the has now ended the uncertainty around making it available."

Ms Phelan, one of the most prominent advocates in the 221-Plus Cervical Cancer Support Group, initially funded her own treatment with Pembro and then had it funded by the State. Minister for Health Simon Harris last year extended this entitlement to all in this cervical cancer group.

The cost of Pembro - up to €8,500 every three weeks - is covered under the Irish health system for melanoma and a small number of others cancers, but not cervical cancer. The drug is not licensed for treating cervical cancer anywhere in Europe, though this kind of off-licence use is permitted where recommended by a treating doctor.

The proportion of cervical cancer patients who respond successfully to Pembro has been estimated to be as low as 15 per cent, but for those for whom it makes a difference - as with Ms Phelan - it can result in a major improvement in quality of life.

The number of women who will benefit from the announcement is expected to be small.

Symptoms of cervical cancer include pelvic pain, irregular vaginal bleeding, bleeding between periods, vaginal spotting or discharge, pain during sex or bleeding after sex. Women with any of these symptoms are advised to contact their GP immediately.

Women of all ages can develop cervical cancer, but it mostly affects women aged 30 to 45 who are sexually active. Cervical cancer is very rare in women under 25.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.