PBAC Public Summary Documents - March 2019 meeting

PBAC

5 July 2019 - The Public Summary Documents (positive recommendations and subsequent decisions not to recommend) from the March 2019 PBAC meeting are now available.

A review of the Public Summary Documents has revealed the following insights that are not apparent from reading the PBAC short minutes:
  • The minor submission for nanoparticle albumin-bound paclitaxel (nab-paclitaxel) requesting the listing of a new strength (250 mg) also included a request for a price increase for its use in pancreatic cancer. The request for a price increase was rejected.
  • In relation to the submission from Roche for the use of atezolizumab in combination with bevacizumab for patients with non-small-cell lung cancer, the PBAC recommended the listing and restrictions proposed in the submission with amendments proposed by the Secretariat to reflect the need for stable or responding disease for continuing treatment, or the need for progressive disease following treatment with tyrosine kinase inhibitors in the EGFR mutant/ALK positive population. The PBAC short minutes do not discuss the PBAC's outcome on the second-line use of atezolizumab and bevacizumab.
  • The Public Summary Document for pembrolizumab for non-small-cell lung cancer reveals the ongoing dispute between the PBAC and MSD. The PBAC did not accept the MSD's argument that the analysis should be based only on the final results of KEYNOTE-042 trial (which require further evaluation), noting that it is not unusual for PBAC to make an assessment of value based on interim results from clinical trials. Furthermore, the PBAC also did not accept as relevant, the sponsor’s claim that an ICER/QALY of $45,000 to $75,000 should be acceptable for pembrolizumab monotherapy in non-small cell lung cancer because it is lower than the ICER/QALY that the PBAC accepted for pembrolizumab for other indications or because it remains within the ranges of the sensitivity analyses considered by the PBAC when it recommended pembrolizumab monotherapy in non-small-cell lung cancer. The PBAC considers the cost-effectiveness of treatments on a case-by-case basis and does not apply a predefined fixed ICER threshold.

Read PBAC Public Summary Documents

Michael Wonder

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Michael Wonder