This breast cancer drug used to cost $3700 a month. From today, it will be much cheaper

It was not until primary school teacher Cath McLardy got out of lockdown-era loose clothes that she realised something may be wrong with one of her breasts.

“I got a dress in the mail and put it on, it had a V-neck and I thought, ‘Oh, one of my boobs is popping out of my bra!’,” says McLardy, who was then aged 38.

Cath McLardy says the fear of recurrence of her breast cancer is with her all the time.Credit: Wayne Taylor

“I was laughing about it with one of my friends, who said, ‘You should probably get that checked.’ ”

Her GP, a breast cancer survivor, suggested she have an ultrasound and mammogram.

Three years on, McLardy has lived through 16 rounds of chemotherapy, 25 doses of radiation and mastectomy to treat the eight-centimetre mass that was discovered beneath one nipple – “which is why I couldn’t feel it”.

“They threw the kitchen sink at me because I was a high risk for recurrence of cancer, it was also in all the lymph nodes,” she says.

At the time, her stage three cancer diagnosis was so confronting that McLardy had difficulty believing she could plan 12 months ahead for a holiday with her husband and two daughters.

She was given compassionate access to a preventive class of medication that could greatly reduce the chance of recurrence, but was not subsidised at the time for those whose cancer was not metastatic (meaning had not spread to a distant location).

Had she not been sponsored, at the time the drugs she was given would have cost her about $4000 a month. “You think, ‘I don’t know how we can find this money’,” McLardy says.

Getting a drug that worked with standard hormone therapy to reduce the chances of cancer returning “felt like hitting the jackpot,” she says, and helped to reduce the nagging sensation “that the Grim Reaper had his hand resting on the back of my shoulder”.

Cathy McLardy says having access to a drug shown to reduce the likelihood of her common type of breast cancer returning helps reduce the feeling “the Grim Reaper has his hand on your shoulder”.Credit: Wayne Taylor

From July 1, one such drug, ribociclib, sold as Kisqali, will be available on the Pharmaceutical Benefits Scheme (PBS) for women in the initial stages of the most common types of early breast cancer – hormone receptor positive (HR+) or human epidermal growth factor receptor 2 negative (HER2-) – and who are deemed at high risk of recurrence because their cancer involves lymph nodes.

The drug is part of a class that targets proteins, known as CDK4/6 inhibitors, involved with division of cancer cells, effectively slowing them down or stopping them from dividing.

The global, multi-centre randomised trial, NATALEE , whose findings are published in The New England Journal of Medicine found adding Kisqali to standard endocrine therapy for early breast cancer patients reduced recurrence risk by 28.5 per cent compared with hormone therapy alone.

The NATALEE trial involved 5101 patients with HR+/HER2- early breast cancer – which accounts for 70-80 per cent of patients – who were randomly assigned to receive either Kisqali plus hormone therapy or only hormone therapy for three years.

Austin Health and Olivia Newton-John Cancer Research Institute oncologist Dr Belinda Yeo said the decision to make Kisqali available to suitable early breast cancer patients would broaden options for treatment intended to cure them.

It could be difficult with early breast cancer to discern “when and to whom” it would return, Yeo said, “so in the Goldilocks zone of trying to get the right treatment for the right patients, the more options the better”.

She described the types of cancer it helps prevent returning as the “garden varieties”, which about 70 per cent of early breast cancer patients have. Around 21,000 people, the vast majority of them women, were diagnosed with breast cancer in 2024.

Dr Sally Baron-Hay, an Australian NATALEE phase two study investigator, said it was great to have another treatment option for early breast cancer patients with high-risk cancer involving multiple lymph nodes, but said not all patients at high risk would be eligible.

“My hope is that all my early breast cancer patients at high risk of cancer recurrence, regardless of how many lymph nodes the cancer has involved, will have access to Kisqali in the future,” she said.

Kirsten Pilatti, chief executive of the Breast Cancer Network Australia (which accepts no funding from pharmaceutical companies), said the organisation supported the listing of Kisqali on the PBS.

Before the listing of Kisqali, women with non-metastatic breast cancer could not access the drug without paying $3700 a month for three years, which some patients do via crowdfunding.

Its listing was important because it ensured equity of care, regardless of patients’ ability to pay for costly medications privately.

“It is important so we don’t have a two-tiered system where only people who can afford it have the benefits,” she said.

“It means more options for precision medicine for oncologists to choose from, for all Australians, regardless of your postcode.”

Pilatti, a member of the federal Health Technology Assessment Review Implementation Advisory Group, said access to Kisqali for early breast cancer patients who fit the criteria would help reduce the significant fear of recurrence many experience.

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