Ways to access new breast cancer drugs

Thanks to clinical trials around the world, new treatments for breast cancer and metastatic breast cancer are being tested all the time.

Once they are approved for use in Australia, some drugs are added to the Pharmaceutical Benefits Scheme (PBS). You only have to pay the small script fee.

But new breast cancer drugs not on the PBS can cost thousands of dollars every month.

We share ways you may be able to access new drugs:

• before they’re listed on the PBS
• sometimes before they’re even approved for sale in Australia.

Join a clinical trial

You may be able to access new treatments not available in Australia through a clinical trial. Your medical oncologist can tell you if any trials are suitable for you.

Read about Clinical trials.

Explore patient access programs

Sometimes, pharmaceutical companies offer ‘patient access programs’. Under these programs, you may be able to access drugs that are approved in Australia but not subsidised through the PBS.

Each scheme runs differently. Some programs offer the drug free of charge but it is more common for you and the company to share the cost.

Example

The pharmaceutical company asks you to pay for the first 2 or 3 treatments. If the drug is shown to be effective for you, they pay for some or all of your treatments until the drug is listed on the PBS or until it stops working for you.

Ask your medical oncologist if any suitable treatments are available via an access program.

Patient access to Perjeta

If you are having neoadjuvant treatment for HER2-positive breast cancer, doctors may recommend a combination of chemotherapy, trastuzumab and pertuzumab (Perjeta).

Chemotherapy and trastuzumab are on the PBS for neoadjuvant treatment, but Perjeta is currently not.

The patient access program reduces out-of-pocket costs of Perjeta but you still need to pay:

• the first cycle of treatment – around $6,500 (as at Jan 2025). The next 5 doses are then provided at no cost
• the pharmacy’s dispensing fee.

You can ask your pharmacist to waive or reduce their fee.

BCNA’s advocacy for affordable new treatments

We want everyone to have access to new drugs for early and metastatic breast cancer. We continue to advocate for new drugs to be available as quickly as possible to those who may benefit. Read about our advocacy work and successes.

Use insurance or superannuation

Private health insurance

Some private health insurance policies allow you to claim benefits towards the cost of drugs not on the PBS. If you have insurance, ask your insurer if you can claim part or all of a particular drug.

Sometimes the pharmacy or doctor can apply to your health fund for a 'high-cost drug' or 'ex gratia' payment for you.
It’s unlikely your insurer will cover the whole cost. Ask your insurer to tell you in writing how much they will cover, if they offer this.

Other insurance policies

If your diagnosis affects your ability to work, you may be able to access your:

• income protection policy
• life insurance policy
• superannuation funds.

Contact your insurer or superannuation fund to ask about your entitlements.

Superannuation

Some superannuation funds allow early access to superannuation for certain reasons including:

• medical treatment
• medical transport
• mortgage help.

Early or compassionate access to superannuation is different between funds. Contact your superannuation fund to find out more.

Find out about:

• Early access to superannuation on the ATO website
• Accessing insurance through your super on the Moneysmart website. 

Pay privately or through fundraising (crowdfunding)

If you can afford it and your medical oncologist is agreeable, you can choose to pay for a new treatment yourself. This is called a ‘private script supply’.

New treatments can be very expensive - often thousands of dollars per months - so this is not an option for most people.
Some people use crowdfunding, which is similar to fundraising.

Many different crowdfunding platforms are available. BCNA has no association with these organisations. Please review their websites and the terms and conditions carefully before using them.

Apply on compassionate grounds

Sometimes, although it is rare, a pharmaceutical company provides a drug free of charge on compassionate grounds.

If you can’t pay for a new drug, ask your medical oncologist if they can apply for you on compassionate grounds.