‘Significant’ treatment to be discontinued: A patient’s perspective

Ashleigh Middleton was just 30 years old when she was diagnosed with breast cancer with the help of her ‘fantastic GP’.
 
She was started on low-dose goserelin (sold as Zoladex) as part of her treatment in 2025 and was told by her oncologist it was ‘really important’ to continue the monthly implant for the next five years.
 
However, an announcement from AstraZeneca means Ms Middleton and thousands of other patients may no longer be able to access the medication from 1 November.
 
‘If I had gone through chemotherapy and radiation, and then the last part of my treatment wasn’t available anymore, it’d be pretty devastating,’ she told newsGP.
 
The manufacturer announced earlier this month that the 3.6 mg monthly Zoladex implant will be removed from the Pharmaceutical Benefits Scheme (PBS) and will also be unavailable via private prescription in Australia.
 
According to figures relating to the number of PBS and RPBS services processed by Services Australia, the 3.6 mg monthly Zoladex implant has been dispensed 29,680 times this year.
 
The decision comes as a 10.8 mg dose of the drug, which is administered as a three-monthly treatment, will remain on the PBS for eligible prostate cancer patients.
 
Ms Middleton, who is also a practice manager at a general practice in Melbourne, learnt of the move from AstraZeneca while at work behind the reception desk.
 
‘I just had a look up at the TV, and it said Zoladex to be discontinued … I looked up and I was like, “no, surely not”,’ she said.
 
‘They said that it’s just commercial reasons that they were getting rid of it, my first thought was, “I’m sure they’ve already gotten PBS approval for the longer one”.
 
‘But that just wasn’t the case … it got my back up a little and the more research that I did, the more cranky I got.’
 
An AstraZeneca spokesperson previously told newsGP it has ‘prepared government regulatory and reimbursement applications to expand availability and access of Zoladex three-monthly implant to include breast cancer patients that are hormone receptor positive as soon as possible’.
 
Ms Middleton is hopeful that these applications come through and her treatment will not be affected.
 
‘I’d be stoked to have it three-monthly, but to even make the announcement without that security for people with cancer is just so traumatic,’ she said.
 
The discontinuation of Zoladex could have significant adverse impacts on affected patients.
 
Ms Middleton says her experience of starting Zoladex was difficult and has her own concerns around gaps in treatment.
 
‘Those menopausal symptoms were very, very hard at the beginning,’ she said
 
‘I’m really hoping that there’s not going to be any stint where I’m not on it’.
 
Zoladex reduces the chance of breast cancer recurrence in certain patient groups. In addition to the potential physical implications, Ms Middleton is candid about the mental load the disruption could cause.
 
‘That chance of recurrence, it could even just be a couple of per cent … that means a lot to me,’ she said.
 
In addition to her experience as a patient, Ms Middleton said the decision will have a broad impact on patients at the clinic she manages, as well as its GPs.
 
‘It will be pretty impactful for a lot of patients,’ she said.
 
‘There’s a couple of patients that we have that are in a similar boat to me, where they’re quite young, and this is that security for them having the Zoladex … reducing that recurrence risk, and then for people that struggle with endometriosis, it’s hard enough.’
 
She praised the ‘fantastic GPs’ that she works with who ‘will find a million different options to one problem’ and that they are always receptive to change, but this move may generate additional work.
 
‘GPs will be able to go with the flow and assess every situation individually … but they shouldn’t have to in this case,’ Ms Middleton said.
 
‘[General practices] do find out things last minute, even government decisions on Medicare, we usually find out through the news.
 
‘We just need to be better about that, so that GPs are prepared.’
 
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