Catherine Cook sold her business to pay out of pocket for Keytruda for her aggressive breast cancer treatment. Photo: Supplied
An Auckland woman who is self-funding treatment for her rare, aggressive breast cancer is fed up after years of asking the government to fund a "life-saving" medicine for more patients.
Catherine Cook, 54, was diagnosed with triple negative breast cancer (TNBC) in November 2024 after her yearly mammogram.
Cook sold her business to pay for Keytruda (also known as pembrolizumab), the only targeted treatment to fight TNBC, given to patients alongside chemotherapy.
Around 10 to 15 percent of breast cancer diagnoses are triple negative, and it is the most challenging type of breast cancer to treat - particularly at the advanced stages, according to Breast Cancer NZ.
But despite Keytruda being recommended by Medsafe for both early and advanced stage of TNBC over two years ago, it had only been funded for advanced patients - not for patients like Cook with early-stage TNBC.
All up, Cook said she expected to pay about $100,000 for Keytruda, with one cycle every three weeks costing her $3000.
"We put the house and the business on the market to see if one or both would go. We ended up selling the business at a $700,000 loss because we simply couldn't afford to pay for a business and treatment at the same time.
"It's absolutely devastating. The guilt that I feel, I mean, basically, I've worked my whole life pretty much for nothing."
Keytruda is funded for early stage TNBC in more than 40 countries, including Australia, the UK and Canada.
In New Zealand, Keytruda is only funded for patients with advanced TNBC, head and neck cancer, colorectal cancer, bladder cancer and Hodgkin lymphoma.
"You get this diagnosis, and you would think there's treatment available because it's standard worldwide to give people Keytruda for early-stage TNBC, and to not have it here is absolutely gut-wrenching," Cook said.
"I had to make a decision to either pay to live or not pay and go Russian roulette, which is what most people have to do. Right now, only a handful, a minority with money, can access treatment through the private health care system."
In November 2025, Cooke presented a 17,000-signature strong petition to widen access to funded Keytruda to the Petitions Select Committee.
She said the committee told her Keytruda for early-stage TNBC had been placed on the Options for Investments List, but there was no timeline for when or if it would be publicly funded.
She said she was told it could take up to a year for an update.
"That absolutely blew me away. In fact, it left me distraught and in tears, wondering why I'd even turned up.
"All we're doing is moving a chess piece on the board. I want to know what the actual plan is.
"But I have to have hope that now it's on the investment list for funding, the problem sits with the government and not with Pharmac."
In November 2025, Pharmac [https://www.rnz.co.nz/news/national/577655/pharmac-could-trim-list-of-medicines-awaiting-funding said it was considering trimming the list of over 100 medicines awaiting funding] to provide patients with more clarity.
Cook said she wanted Finance Minister Nicola Willis to meet with her in person.
"I want to sit down with her woman-to-woman to let her know that early intervention not only saves lives but will save the government money long-term.
"Dragging people on a journey where they can't afford treatment and have to be a burden on the health system, the mental health system and welfare, is costing the government a huge amount of money.
"Nicola, if saving lives is not your top priority - which it should be, - let me show you how to save money."
The Breast Cancer Foundation's head of research and strategic programmes Mehdi Shahbazpour said New Zealand was missing an opportunity to save lives by not treating breast cancer earlier.
He said, unlike other countries, New Zealand only had funding to extend the life of breast cancer patients who had reached an advanced, incurable stage.
Kisqali (also known as ribociclib), a treatment for hormone receptor-positive breast cancer, started being funded for early stage patients in Australia in 2025. But in New Zealand, it was also only funded for advanced patients.
"A lot more targeted therapies are the standard of care internationally. Women have had access to these medicines funded in comparable nations for many years," Shahbazpour said.
"If we get more funding for medicine for early breast cancer patients, we actually have an opportunity to reduce the chance of cancer coming back and spreading to the rest of the body and making it terminal."
"Time is the enemy of breast cancer patients. This is our best chance to contain the cancer as early as possible."
Shahbazpour said the government needed to ensure Pharmac had the budget it needed, so women like Catherine were not forced to fork out thousands of dollars or go without.
"We have a medicines crisis. We are way behind comparable nations when it comes to funding medicines.
"It's costing lives and destroying lives. People have to put their homes up for a mortgage or go to Australia to afford these life-saving medicines through private channels."
In a statement, Pharmac pharmaceuticals director Adrienne Martin told RNZ they could not give any indication of when or if Keytruda specifically would be funded for early stage TNBC, or where it was ranked on the Options for Investment List.
"We understand how difficult it can be when someone is living with a serious health condition and needs access to medicines. We acknowledge there is a high unmet health need for people with breast cancer and a need for more effective treatments.
"Our team works hard to fund as many medicines as possible using the best available clinical evidence, expert advice, and the lived experiences of New Zealanders.
"In September, following a petition from a member of the public, Pharmac was invited to present a submission to the Petitions Select Committee. In the submission, Pharmac confirmed that it was close to finishing its assessment of pembrolizumab (Keytruda) for early-stage triple negative breast cancer. After this, the application would be ranked on Pharmac's Options for Investment List (OFI).
"Pharmac's submission also included information about the length of time it had taken for the medication to be added to the OFI. The assessment process began in 2023, and the medicine was added to the OFI in 2025.
"We noted in our submission that when this funding application was considered by Pharmac's Cancer Treatments Advisory Committee in October 2023, the Committee recommended that this medicine be funded for people with early-stage triple negative breast cancer with a low priority. This information was provided to help explain the length of time the assessment process had taken."
In New Zealand, women between the ages of 45 and 69 years can get free breast screening every two years.
Finance Minister Nicola Willis and Pharmac Minister David Seymour both declined to comment directly.
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