← The record

Ezetimibe And AtorvastatinAtozet

Not recommended CardiovascularAuthority RequiredNot applicable line

Hypercholesterolaemia in combination with dietary therapy and exercise where cholesterol levels are inadequately controlled by atorvastatin and patients have hypertension, coronary heart disease (or a family history), diabetes, peripheral vascular disease, heterozygous familial hypercholesterolaemia or cerebrovascular disease; also for homozygous familial hypercholesterolaemia and for patients who have developed clinically important statin-related adverse events necessitating dose reduction.

4
Submissions
3 resub
2012–13
On the record
ICER range
Cost-min
Cost basis

Decisions on record

2 decisions
  • Meeting Nov 2012 Not recommended At the time of PBAC consideration, Atozet Composite Pack’s TGA registration was yet to be finalised.
  • Meeting Jul 2012 Not recommended High cholesterol

Access path

4 submissions · public record
  1. TGA registered · Atozet

    TGA label narrower than the PBS population

  2. Jul 2012
    Recommended

    vs corresponding doses of ezetimibe and atorvastatin given…

  3. Nov 2012
    Not recommended

    concerns over labelling and packaging of co-pack and risk of incorrect use by patients; superiority over…

  4. ↻ resubmitted
    Nov 2012
    Recommended

    Comparator changed: corresponding doses of ezetimibe and atorvastatin given…

  5. Jul 2013
    Recommended · restricted

    Comparator changed: ezetimibe and atorvastatin given concomitantly; secondary comparator:…

  6. PBS listing · Authority Required
RecommendedDeferredNot recommended

Cost-effectiveness

Cost-minimisation analysis; no ICER calculated. Submission based on non-inferiority for LDL-C reduction.

The submission presented a cost-minimisation analysis, which was based on a non-inferiority claim for LDL-C reduction, not including additional costs/offsets for administration/adverse events. PBAC · 2013
Economic model disputedSurrogate endpoint ×2Indirect comparison

Decision context

PopulationPatients with hypercholesterolaemia inadequately controlled by atorvastatin and at least one of: hypertension, coronary heart disease, family history of coronary heart disease, diabetes mellitus, peripheral vascular disease, heterozygous familial hypercholesterolaemia, or symptomatic cerebrovascular disease; also patients with homozygous familial hypercholesterolaemia; and patients who developed clinically important statin-related adverse events.

Submission history

4 entries
DecidedOutcomeComparatorICEREvidence
Jul 2013 Recommended · restricted co-administration of ezetimibe and atorvastatin components concomitantly; ezetimibe/simvastatin fixed-dose combination ( Cost-minimisation · Cost-minimisation
Nov 2012 Not recommended corresponding doses of the components (ezetimibe and atorvastatin) given concomitantly, with ezetimibe/simvastatin fixed RCT · LDL-C reduction
Nov 2012 Recommended ezetimibe and atorvastatin given concomitantly; secondary comparator: ezetimibe with simvastatin fixed dose combination RCT · LDL-C
Jul 2012 Recommended corresponding doses of ezetimibe and atorvastatin given concomitantly, with ezetimibe/simvastatin fixed dose combination RCT, indirect comparison · LDL-C reduction

Similar precedents

By decision profile

Regulatory · TGA

Label narrower than PBS population — PBAC restricts to patients with specific cardiovascular risk factors or inadequate atorvastatin control; TGA label permits broader adjunctive use.