‘Weighing up your mortality, with a calculator in your hand’: the $75,000 decision faced by two Kiwi mums

Sunday, 21 June 2026

Breast cancer patients are being forced to find $6000 a month for a drug that would significantly improve their odds of avoiding a deadly relapse.

They include nurse and mother of three, Tessa Attwood, who says the added stress of putting her young family under financial strain is “awful”.

Auckland communications advisor Angela Palmer has chosen to spend the money, “to increase the chances of seeing my grandchildren through their teens”.

Breast cancer patients are being forced to find $6000 a month for a drug that would significantly improve their odds of avoiding a deadly relapse. Nicholas Jones reports.

Tessa Attwood is thankful she didn’t dismiss the small lump she felt in her breast.

“I had pain in my armpit, but no family history, nothing that would ever make me think I might have cancer,” the 37-year-old says.

“But because I'm a nurse and I've seen lots of women coming through in a similar situation, and I've got three young kids, I thought, ‘I have to get this checked out.’”

In December last year Tessa - a mum to a 10, eight and five-year-old - was diagnosed with breast cancer (stage 2b, meaning it had reached some of her lymph nodes).

She had a mastectomy in January, began chemotherapy in February, and will then have radiotherapy. Tessa will also have 10 years of endocrine (hormone) therapy, which blocks hormones that cause her breast cancer to grow faster.

Tessa began her treatment in the public system, but through her past work at Southern Cross Hospital had basic health insurance, so switched into the private system, where her oncologist offered another treatment, abemaciclib (brand name Verzenios).

This belongs to a class of medicines called CDK4/6 inhibitors. Abemaciclib targets proteins on breast cancer cells that stimulate them to divide and grow.

For some patients, adding such an inhibitor to standard hormone therapy can significantly reduce the risk of cancer returning. Preventing breast cancer from recurrence is crucial because once it spreads to other parts of the body, it’s generally considered to no longer be curable.

Because of this, many countries including Australia and the United Kingdom have funded access to CDK4/6 inhibitors for “early-stage” breast cancer (cancer that has not spread to other organs).

A Pharmac advisory committee has recommended abemaciclib be funded for early-stage HR positive, HER2 negative breast cancer with a high priority.

The drug-buying agency’s assessment process is ongoing. Even when complete, the medicine would join an “options for investment” list - the list of medicines Pharmac would like to fund, if or when money becomes available.

There are more than 100 medicines currently on the list (Pharmac publishes the names, but not how the medicines are ranked by priority), some of which have been there for years.

In the meantime, patients like Tessa must pay about $75,000 for a two year course of abemaciclib, under a cost-share programme with the pharmaceutical company Eli Lilly.

She understands taking abemaciclib could boost her chances of remaining cancer-free by about 5%. Tessa and her husband, a video editor, are working out how they might afford those improved odds.

“It's quite stressful knowing that you're putting such a financial strain on your family for the foreseeable future, it just feels really awful,” she says, her voice breaking with emotion.

“If I survive 10 extra years, then I can earn that money. But if I die, that's a huge financial burden for my husband and my family.

“To be a solo parent to three kids would be far more financially draining, so that is why we will prioritise it and hope for the best. It could always still re-occur, but at least we'll know that we've thrown everything that's available to us at it, and hopefully I will live a long life, or at least get to see my kids become adults.”

‘You're weighing up your mortality’

Others making similar calculations include Auckland communications advisor Angela Palmer, who has chosen to spend the money, “to increase the chances of seeing my grandchildren through their teens”.

Angela, 61, was diagnosed with hormone receptor positive breast cancer in September last year, after a regular mammogram. Biopsies found the disease in her lymph nodes.

“I have had four sisters with breast cancer, but all at different ages and stages, and different types, and, so far, there's been no genetic link discovered. So I wasn't shocked or surprised to find that I had breast cancer, but I was shocked that it was stage three.”

Angela has had two surgeries, 20 weeks of chemo, is in the midst of three weeks of radiotherapy, and has started hormone therapy that will last a decade.

Her oncologists have recommended abemaciclib. Angela has kept working through her arduous treatment, and had hoped to reduce her hours at some point, but will keep full-time in order to meet the cost.

She understands having the medicine could increase her chances of survival by about 10%.

“I feel like I can't afford not to,” says Angela, who has adult children and two grandchildren, both aged under five.

“It hurts, but I can make it work. I'm feeling very lucky that I can … I know for some people it's an even harder decision. You're weighing up your mortality, with a calculator in the other hand.”

Medicines budget ‘inadequate’

Pharmac received an application to fund abemaciclib in May 2024, which its advisory committee recommended for funding, with a high priority, in November 2025.

“We are now completing an assessment using the factors for consideration. This includes looking at who might benefit from this medicine, the benefits of the medicine compared with already funded treatments, its suitability for use in New Zealand, and the cost and cost-effectiveness of the medicine,” said Caroline De Luca, Pharmac’s acting director for advice and assessment, in a statement.

Pharmac currently funds two other CDK4/6 inhibitor medicines for people with certain breast cancers that have spread to other parts of the body, covering around 900 patients a year.

It is considering a separate application to fund abemaciclib for metastatic breast cancer, and an advisory committee has recommended that happen if it was cost neutral, noting Pharmac already funds other CDK4/6 inhibitors for later-stage breast cancer.

Mehdi Shahbazpour, Breast Cancer Foundation NZ’s head of research and strategic programmes, told Stuff that the situation for patients like Tessa and Angela is unacceptable.

“The reality is that a treatment costing around $6,000 a month is simply out of reach for many New Zealand families. No one should be placed in a position of having to choose between financial security and a treatment their doctor believes could give them a long-term chance of a cure.”

Shahbazpour said Pharmac takes more than three years, on average, to make a funding decision on a medicine, and even after that point, patients can wait years because the agency is contending with a “fixed and inadequate budget”.

“Preventing recurrence can reduce the need for ongoing treatment, hospital visits and the significant costs associated with managing advanced breast cancer over many years. We should be thinking not only about the cost of medicines today, but also the future costs of breast cancer recurrence.”

That point is also made by both Angela and Tessa.

“I worked in Starship for 11 years, and in South Auckland as a nurse, and for a lot of families, if you can't put shoes on your kids’ feet, or food on the table, or petrol in your car, this is not an option for you, it's never going to be an option,” Tessa says.

“There is a huge inequity there … I always trusted that the health system is fair, when I was first working as a nurse, but now it seems far less so. I’m not getting political, because it's on both [left and right] sides that it has happened, it’s just the way that New Zealand has gone.”