The latest positive recommendations from PBAC include an extension of indication for lenalidomide to patients with newly diagnosed multiple myeloma (NDMM) who are ineligible for a primary stem cell transplant.
At its August 2019 meeting, the PBAC recommended the listing of lenalidomide in combination with bortezomib and dexamethasone (RVd) for the treatment of patients with NDMM on the basis that it should be available only under special arrangements under Section 100 – Highly Specialised Drugs Program.
“The PBAC was satisfied that RVd provides, for some patients, a significant improvement in efficacy over lenalidomide plus dexamethasone (Rd) and bortezomib in combination with melphalan and prednisolone (VMP) and acknowledged the clinical need for triplet combination therapy in the NDMM setting,” it said.
The extension applies to the 5 mg, 10 mg, 15 mg and 25 mg capsules of lenalidomide.
The PBAC considered that the incremental use of bortezomib was cost effective at no more than the current net price.
“The PBAC considered that the incremental use of lenalidomide would be cost-effective if expenditure was capped at no higher than the estimates provided in the submission, implemented through a Risk Sharing Arrangement, together with a price reduction to address the uncertainty in the incremental cost-effectiveness ratio (ICER) of RVd versus bortezomib in combination with melphalan and prednisolone (VMP).”
Iron deficiency anaemia
At the same meeting, the PBAC also recommended the unrestricted listing of a new form of ferric derisomaltose, 1000 mg/10 mL for iron deficiency anaemia.
The PBAC noted the new form would be covered by the existing financial arrangements for iron deficient anaemia and would be listed at no additional cost to Government.
It also recommended an increase of the maximum quantity of prescriptions to three and a reduction in the number of repeats to zero for the current listing for ferric derisomaltose 500 mg/10 mL solution for injection to allow patients to receive the maximum quantity of 1500 mg per prescription.