← The record

Glatiramer AcetateCopaxone

Recommended NeurologyAuthority RequiredNot applicable line 💬 consumer voice

Treatment of multiple sclerosis. The submission requested listing a new form of 40 mg glatiramer acetate pre-filled pen under the same circumstances as the PBS-listed 40 mg glatiramer pre-filled syringe.

4
Submissions
2015–22
On the record
ICER range
Cost-min
Cost basis

Decisions on record

4 decisions
  • Meeting Mar 2022 Recommended Multiple sclerosis
  • Meeting Mar 2021 Recommended Multiple sclerosis
  • Meeting Jul 2017 Not recommended Clinically isolated syndrome (CIS)
  • Meeting Mar 2015 Recommended Multiple sclerosis

Access path

4 submissions · public record
  1. TGA registered · Copaxone

    TGA label equal than the PBS population

  2. Mar 2015
    Recommended

    vs glatiramer acetate 20 mg/mL daily

  3. Jul 2017
    Not recommended

    Uncertain whether the population defined in the restriction was representative of patients at high risk of developing…

  4. ↻ resubmitted
    Mar 2021
    Recommended

    Comparator changed: Placebo → Copaxone (glatiramer acetate)

  5. Mar 2022
    Recommended

    Comparator changed: Copaxone (glatiramer acetate) → glatiramer acetate 40 mg pre-filled…

  6. PBS listing · Authority Required
RecommendedDeferredNot recommended

From the public summary

Verbatim · PSD text · may span indications
PBAC outcome
6.1 The PBAC recommended the listing of a new form of 40 mg glatiramer acetate pre- filled pen (GA PFP) under the same circumstances as the PBS-listed 40 mg glatiramer pre-filled syringe (GA PFS) for the treatment of multiple sclerosis.PSD · Mar 2022
6.2 The PBAC recommended listing GA PFP on a cost-minimisation basis to the PBS-listed GA PFS. The PBAC noted the listing of GA PFP is expected to have no net cost to the PBS.PSD · Mar 2022
Economic analysis
5.9 As a minor submission, the economic analysis has not been independently evaluated.PSD · Mar 2021
5.10 The minor submission presented a cost-minimisation analysis of Glatira compared with Copaxone. The minor submission estimated the equi-effective doses to be:  20 mg Glatira = 20 mg Copaxone  40 mg Glatira = 40 mg CopaxonePSD · Mar 2021
Clinical claim
5.3 The submission claimed non-inferior comparative effectiveness and non-inferior comparative safety of the GA PFP compared with the GA PFS.PSD · Mar 2022
5.4 The Therapeutic Goods Administration (TGA) confirmed that GA PFP and GA PFS are the same, noting that GA PFS is integrated into a GA PFP.PSD · Mar 2022
Consumer comments
5.2 The PBAC noted and welcomed input from an individual (1) and an organisation (1) via the Consumer Comments facility on the PBS website. The PBAC noted that both the individual and MS Australia’s comments described a range of benefits of treatment with GA PFP, including easier administration, reduced adverse effects, improved adherence, and an option for patients with reduced dexterity.PSD · Mar 2022
Financial management – risk sharing
6.81 The sponsor did not propose a risk share arrangement, stating that it would be difficult in practice to effectively separate clinically isolated syndrome from multiple sclerosis prescribing, which would possibly result in pre-defined annual risk share caps being inadvertently exceeded. No special pricing arrangement was sought by the sponsor.PSD · Jul 2017

Cost-effectiveness

Cost-minimisation analysis; no ICER calculated as submission assumed no differences in utilisation of healthcare resources between formulations.

The PBAC recommended listing GA PFP on a cost-minimisation basis to the PBS-listed GA PFS. PBAC · 2022
Cost-effectiveness accepted

Decision context

PopulationPatients with multiple sclerosis treated with glatiramer acetate 40 mg

Submission history

4 entries
DecidedOutcomeComparatorICEREvidence
Mar 2022 Recommended glatiramer acetate 40 mg pre-filled syringe (GA PFS) Cost-minimisation · Cost-minimisation
Mar 2021 Recommended Copaxone (glatiramer acetate) RCT · MRI (gadolinium-enhancing lesions)
Jul 2017 Not recommended Placebo RCT · Time to conversion to clinically definite multiple sclerosis
Mar 2015 Recommended glatiramer acetate 20 mg/mL daily Meta-analysis · ARR

Clinical evidence

Trials cited in the PSDs · ClinicalTrials.gov
TrialPhaseNPrimary outcomeStatus
PreCISe Ph 3 481 Time to Clinically Definite Multiple Sclerosis (CDMS) Conversion completed
GTR001 (GATE Study) Ph 3 794 The Number of T1-Gadolinium Enhancing Lesions During Months 7-9 completed
GALA Ph 3 1,404 Total Number of Confirmed Relapses During the Placebo Controlled (PC) Treatment Period Est… completed

Consumer voice

Mar 2022

An individual and MS Australia provided consumer input describing benefits of glatiramer acetate pre-filled pen (GA PFP) treatment, including easier administration, reduced adverse effects, improved adherence, and suitability for patients with reduced dexterity.

both the individual and MS Australia's comments described a range of benefits of treatment with GA PFP, including easier administration, reduced adverse effects, improved adherence, and an option for patients with reduced dexterity Consumer comments · PSD
ease of administrationreduced adverse effectsimproved adherenceaccessibility for patients with reduced dexterityneedle stick injury reduction

Similar precedents

By decision profile

Regulatory · TGA

Label equal than PBS population — Both TGA label and PBAC recommendation cover treatment of multiple sclerosis with glatiramer acetate 40 mg; no population restriction applied.