PBAC's latest decision on Netupitant and palonosetron: Recommended with restriction (2015). Considered for Prevention of nausea and vomiting associated with initial and repeat courses of highly emetogenic chemotherapy (HEC) and anthracycline plus cyclophosphamide (AC) based regimens in patients with breast cancer.
PBAC outcome
Recommended with restriction
Authority Required
ICER (AUD/QALY)
Cost-min
cost-minimisation analysis
Submissions
1
first 2015
Submissions
1
2015 → 2015
Eligible population
Adult patients scheduled to receive initial and repeat courses of highly emetogenic chemotherapy (HEC) and patients with breast cancer scheduled to receive anthracycline plus cyclophosphamide (AC) based regimens, in combination with dexamethasone.
Therapy area
Oncology
Line of therapy
Not applicable
Evidence base
RCT
Primary endpoint
Prevention of nausea and vomiting
Key trials
NETU-08-18, NETU-10-29, NETU-07-07
Comparator
aprepitant plus a 5-HT3 receptor antagonist
Economic model
Cost-minimisation
ICER note
Cost-minimisation analysis presented; PBAC noted the economic evaluation was a cost comparison rather than a cost-minimisation analysis. No ICER calculated.
Risk sharing
Risk-sharing arrangement in place — Risk sharing arrangement proposed where any usage beyond proposed estimates for NK1 RA use in HEC and AC breast cancer would be subject to a rebate of 30% of the cost of Akynzeo. PBAC advised that a risk sharing arrangement should include a subsidisation cap where higher than expected use of NEPA defaults to the equivalent cost of a 5-HT3 receptor antagonist, based on estimates of NEPA use in HEC and AC breast cancer indications.