PUBLIC FUNDING OF CANCER TREATMENT- CHANGES TO THE PROCESS AND SUCCESS RATE OVER TIME IN AUSTRALIA
Author(s)
O'Leary BA1, Gordois AL1, Quadri H1, McElroy HJ2
1Covance Market Access Services Inc., Sydney, Australia, 2Covance (Asia) Pte Ltd., Singapore, Singapore
OBJECTIVES: The complexity of manufacturing biologics and small patient populations means that oncology medicines are frequently high cost and struggle to meet the cost-effectiveness criteria in countries with HTA reimbursement systems. Further, data limitations due to cross-over designs and immature survival data mean there is uncertainty regarding long term clinical benefit. In 2012 we reported on the outcomes of submissions lodged to the Australian PBAC between 2005 and 2011 for oncology medicines seeking a price premium relative to the comparator. We repeated the analysis for 2012–2016 to explore changes to the process and success rate. METHODS: : We searched our internal database of Public Summary Documents (PSDs) published 2012 – 2016 to identify submissions for oncology presenting an economic evaluation to support a price premium compared with the comparator. The dataset was supplemented with manual searching. RESULTS: We identified 116 relevant PSDs; 53 for first, 40 second and 23 for subsequent submissions. Of the 53 first submissions, 8 (15%) were recommended, 8 (15%) deferred and 37 (70%) rejected. The success rate increased for second (16/40, 40%) and subsequent submissions such that overall 38/53 (72%) eventually received a positive recommendation. The success rate for initial submissions was comparable to the 2012 analysis (9/45, 20%), however there was a higher success rate with the second submission (40% vs 32%). Overall success rate was slightly higher (72% vs 62%). A small number of submissions overcame a decision of rejection or deferral to be recommended at an out of session meeting. A number of others resubmitted after a positive recommendation to address pricing issues. CONCLUSIONS: As in the 2012 analysis, a small proportion of initial submissions receive a positive recommendation. There is evidence of a higher success rate for second submissions, as well as increased dialogue between sponsors and the PBAC to resolve outstanding issues.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PHP136
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
Multiple Diseases