25 August 2020 - More insights extracted by the MAESTrO Team from the outcomes from the July 2020 PBAC meeting.

• The PBAC recommended the listing of fulvestrant for the first-line treatment of patients with unresectable advanced or metastatic breast cancer. The Committee considered the incremental cost effectiveness ratio is uncertain, which could be addressed through a price reduction. The PBAC considered that a reduction in price for subsequent line use was also appropriate, given the high level of uncertainty in the clinical evidence presented. This appears to be a new development; a recommendation for a price reduction for multiple lines of use.
• The PBAC has continued to recommend medicines on the basis of a cost minimisation basis against the lowest/least cost alternative. Seven medicines were recommended this way in July. We will have more to say on this in a later issue of MAESTrO Daily.
• On the flip side, the PBAC recommended a price premium/advantage for two medicines (dulaglutide, paracetamol)
• Seven medicines were recommended with a risk sharing agreement
• No medicines were recommended with a managed entry scheme/managed access program
• There is no real world evidence to indicate that real world data was used to drive a single PBAC recommendation (let alone an outcome).