Management Secrecy - A Threat to Health and Safety

Members will be aware that a trial of the use of gas flush meat is being carried out in Coles Myer stores. It is clear that Coles Myer are increasing the numbers of stores that are being supplied from a centralised company who are providing the gas flushed meat.

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Alimta and Mesothelioma Access to Treatment for Mesothelioma in Australia is not equal for all Information from the Asbestos Diseases Society of Victoria (ADSVIC)   What is Mesothelioma? Mesothelioma is a rapidly fatal cancer of the lining of the lung, usually associated with exposure to asbestos[i]. Australia has the highest rate of mesothelioma in the world[ii]. Mesothelioma is generally diagnosed 20 to 40 years after asbestos exposure. There has been a four to five-fold increase in the rate of mesothelioma since the early 1980s[iii], fuelled by exposure to asbestos during the mid 1900s. It is estimated that this rate will continue to increase for the next five to 10 years, with peak incidence between 2015 and 2018. Mesothelioma patients have been exposed to asbestos by no fault of their own. The dangers of asbestos only became widely publicised in the 1980s. Those at highest risk include anyone who has worked with asbestos, and their family members, in jobs such as mining, milling, manufacturing, construction, power generation and in the navy, railway and shipbuilding industries[iv]. Many of these industries were government-owned. Owners and renovators of homes built before the 1980s are also increasingly at risk of asbestos exposure and mesothelioma[v]. What is the standard treatment for Mesothelioma? Mesothelioma is an extremely difficult cancer to treat. Surgery is possible only in a small number of cases. People who cannot have surgery typically survive only 6 months on average with supportive care only[vi]. Alimta (pemetrexed disodium) is a chemotherapy agent for the treatment of non-small cell lung cancer and mesothelioma. Alimta is the only treatment registered for use in mesothelioma, and in combination with cisplatin, represents the standard of care for mesothelioma treatment in Australia[vii]. When people with mesothelioma are treated with the standard of care their survival time can be significantly increased[viii]. On average, patients survive by more than a year from diagnosis[ix]. In some cases, this can be significantly longer. This time is very meaningful when confronted with diagnosis of a rapidly fatal cancer. The standard of care treatment combination not only significantly increases patient survival time, but also improves quality of life in terms of fatigue, loss of appetite, pain and cough[x]. Who gets access to the standard mesothelioma treatment now? Alimta is already listed on the Pharmaceutical Benefits Scheme (PBS) for use in non small cell lung cancer, but is not approved for use in patients with mesothelioma. The manufacturer of Alimta, Eli Lilly Australia, has made three unsuccessful submissions to the Pharmaceutical Benefits Advisory Committee (PBAC) to have Alimta PBS-reimbursed for treatment of mesothelioma. Eli Lilly has now made a fourth submission to the PBAC, which will be considered at its November 2007 meeting. Currently, access to Alimta for mesothelioma patients is inequitable across Australia. Different states and companies provide various schemes to compensate victims of asbestos exposure, but some patients (especially those with non-occupational exposure) end up paying for Alimta privately, at great expense. A course of treatment for Alimta over 18 weeks costs in excess of $18,000, excluding other therapies. Patients treated successfully may need to pay for multiple courses of treatment. What action is needed to improve equity of access? The current inequity of access to Alimta across Australia needs to change. There is strong support for this from asbestos victim support groups, medical oncologists and, most importantly, the patients themselves. Access to Alimta for mesothelioma patients needs to be guaranteed nationally, ideally through PBS listing. If the PBAC will not approve Alimta for treatment of mesothelioma under its current rules, alternative funding needs to be identified. It would only cost the Federal Government around $5-7 million per year to resolve the current inequity and approximately $33m over 5 years. Alimta is subsidised for mesothelioma in most other OECD countries, such as France, Germany, Sweden, Korea and Japan. The expert clinical body in the United Kingdom has also approved its use for patients, recognizing the particular nature of mesothelioma as a terminal disease resulting from asbestos exposure. Australia has the highest rate of mesothelioma in the world. Australians with this terrible disease should have access to the best standard of care regardless of where they live or how they were exposed to asbestos. Everyone with mesothelioma deserves equal access to Alimta The chemotherapy drug Alimta is the preferred treatment for mesothelioma when used together with another chemotherapy agent, Cisplatin. However, Alimta is being denied to between 30 and 50% of all mesothelioma patients around Australia because it isn’t listed on the on the PBS as a subsidised medicine. It is time that the Pharmaceutical Benefits Advisory Committee listed the drug and they have another chance at their October 31 – 2 November meeting when the manufacturer Eli Lilly puts the fourth submission for listing since 2003. And with the numbers of mesothelioma cases continuing to climb until a they peak in around 2018 this is an issue that won’t go away. Asbestos advocacy groups around the country are campaigning for a fair go for mesothelioma patients and their families. You can help! Go to the very bottom of this page for a draft letter to the important decision makers who are listed in the second document.  Please remember it is only a draft and the more you make the letter your own it is more likely the politician or PBAC will read it. Make sure you also write to your local federal MP (for their electorate office and contact details see http://www.aph.gov.au/). Better still, ring them up or go and see them.   For more information, go to the ADSVIC website. Countries where Alimta is reimbursed for mesothelioma (not exclusive) Japan Greece Romania Korea Hungary Slovakia Austria Italy Slovenia Belgium Latvia Spain Czech Republic Lithuania Sweden Finland Netherlands Switzerland France Norway Turkey Germany Poland UK Note: Many of these countries provide reimbursement entirely through hospital settings, however in most cases, reimbursement is universal and not limited by budget. Only Western Australia provides universal cover through hospitals in Australia. References [i] Asbestos Diseases Society of Australia INC, 1997. Asbestos, what you should know. Western Australia, Hart Printing. [ii] Leigh J, et al. Malignant Mesothelioma in Australia, AM J Ind Med. 2002 Mar;41(3):188-201 [iii] Boyer M, Byrne M, Clarke S. Alimta: a new treatment option for malignant mesothelioma. Reviews in Clinical Oncology, 2003; 1: 4 - 8. [iv] Asbestos Diseases Society of Australia INC, 1997. Asbestos, what you should know. Western Australia, Hart Printing. [v] Asbestos Diseases Society of Australia INC, 1997. Asbestos, what you should know. Western Australia, Hart Printing. [vi] Vogelzang NJ et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with MPM, J Clin Onc 2003, 21(14): 2636-2644 [vii] Vogelzang NJ. Standard therapy for the treatment of malignant pleural Mesothelioma. Lung Cancer 2005; 50 (Suppl.1): S23–4. [viii] The Cochrane Database of Systematic Reviews 2007. Issue 2: Green J, Dundar Y, Dodd S, Dickson R, Walley T. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural Mesothelioma. Art. No.: CD005574. DOI: 10.1002/14651858.CD005574.pub2 [ix] N J Vogelzang, J T Symanowski, J J Rusthoven, C Manegold, M Boyer, B Nguyen, P Paoletti, unpublished data. [x] The Cochrane Database of Systematic Reviews 2007. Issue 2: Green J, Dundar Y, Dodd S, Dickson R, Walley T. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural Mesothelioma. Art. No.: CD005574. DOI: 10.1002/14651858.CD005574.pub2