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IvabradineAPO-IVABRADINE

Recommended CardiovascularAuthority RequiredNot applicable line

Chronic heart failure in symptomatic patients (NYHA classes II or III) with reduced left ventricular ejection fraction (≤35%) and elevated resting heart rate (≥77 bpm) on optimal standard heart failure treatment.

4
Submissions
3 resub
2011–15
On the record
$15k–200k
ICER range
2 sourced ICERs · 2011–2012
Not modelled
Cost basis
risk sharing

Decisions on record

6 decisions
  • Meeting Mar 2015 Recommended Chronic heart failure
  • Meeting Nov 2012 Not recommended Treatment of chronic stable angina due to atherosclerotic coronary artery disease in patients with normal sinus rhythm, who are unable to tolerate or have a contraindication to the use of beta-blockers, OR in combination with atenolol 50 mg once daily when heart rate is at or above 60 beats per minu no PSD
  • Meeting Jul 2012 Deferred Heart failure
  • Meeting Nov 2011 Not recommended Heart failure
  • Meeting Jul 2008 Not recommended Treatment of chronic stable angina due to atherosclerotic coronary artery disease in patients with normal sinus rhythm who are unable to tolerate or have a contraindication to the use of beta blockers.
  • Meeting Nov 2007 Not recommended Angina (heart pain due to lack of oxygen reaching the heart)

Access path

4 submissions · public record
  1. TGA registered · APO-IVABRADINE
  2. Nov 2011
    Not recommended

    high uncertainty around clinical evidence, applicability of SHIfT trial to Australian setting (dominated by Eastern…

  3. ↻ resubmitted
    Jul 2012
    Recommended

    ICER rose $45,000 → $200,000 (+344%)

  4. Jul 2012
    Deferred

    ICER rose $45,000 → $200,000 (+344%)

  5. Mar 2015
    Recommended · restricted
  6. PBS listing · Authority Required
RecommendedDeferredNot recommended

From the public summary

Verbatim · PSD text · may span indications
PBAC outcome
6.1 The PBAC recommended amending the listing of ivabradine from Authority Required to Authority Required (Streamlined).PSD · Mar 2015
6.2 The PBAC also recommended a change to the restriction wording to include echocardiography as an alternative diagnostic test to electrocardiogram (ECG). The PBAC considered that echocardiography is regularly used in clinical practice, and that the change was therefore appropriate.PSD · Mar 2015
Economic analysis
5.3 As a minor submission, no economic comparison was presented.PSD · Mar 2015

Cost-effectiveness

2 sourced ICERs · 2011–2012

Minor submission; no economic comparison presented.

As a minor submission, no economic comparison was presented. PSD · 2015
ICER uncertain

Decision context

PopulationAdults with chronic heart failure, NYHA classes II or III, in sinus rhythm, with left ventricular ejection fraction ≤35%, resting heart rate ≥77 bpm, receiving optimal standard chronic heart failure treatment including maximum tolerated dose beta-blocker.

Risk sharingRisk share agreement (RSA) in place; expenditure estimated at 39% below first year RSA threshold.

Submission history

4 entries
DecidedOutcomeComparatorICEREvidence
Mar 2015 Recommended · restricted RCT
Jul 2012 Recommended placebo (standard medical management) $15k–200k RCT · OS | PFS | DFS | ORR | QoL | Surrogate | Cost-minimisation | Other | null
Jul 2012 Deferred placebo (standard medical management) RCT · CV_death_or_HF_hospitalisation
Nov 2011 Not recommended placebo (standard medical management) $15k–45k RCT · OS | PFS | DFS | ORR | QoL | Surrogate | Cost-minimisation | Other | null

Clinical evidence

Trials cited in the PSDs · ClinicalTrials.gov
TrialPhaseNPrimary outcomeStatus
SHIFT Ph 3 6,505 Primary Composite Endpoint: First Event Among Cardiovascular Death (Including Death of Unk… completed
SIGNIFY Ph 3 19,102 Primary Composite Endpoint completed

Similar precedents

By decision profile

Regulatory · TGA