Gaps in funded cancer medicines between New Zealand and Australia can have significant implications for patients and their families. Pharmac, the New Zealand pharmaceutical funding agency, has been criticised for not funding enough cancer medicines, and a 2022 review identified ethical concerns about its utilitarian focus on efficiency. However, as the costs of new cancer medicines rise along with public and political pressure to fund them, questions about value for money remain critical for health systems worldwide. In this paper, we (...) compare funding for cancer medicines in New Zealand and Australia, specifically medicines for non-small cell lung cancer. We argue that the ethical imperatives on funding agencies to get value for money and provide medicines for patients with cancer underscore the importance of transparent decision-making processes, including identifying and explaining intercountry differences in funded medicines. (shrink)