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NilotinibTasigna

Recommended HaematologyAuthority RequiredFirst-line line

First-line treatment of chronic phase Philadelphia chromosome positive chronic myeloid leukaemia (Ph+ CML-CP)

2
Submissions
2008–11
On the record
ICER range
Cost-min
Cost basis

Decisions on record

5 decisions
  • Meeting Nov 2012 Recommended Leukaemia no PSD
  • Meeting Nov 2011 Recommended Anti-cancer drug no PSD
  • Meeting Jul 2011 Recommended Chronic myeloid leukaemia
  • Meeting Jul 2008 Recommended Chronic myeloid leukaemia (CML) no PSD
  • Meeting Mar 2008 Recommended Chronic Myeloid Leukaemia (CML)

Access path

2 submissions · public record
  1. TGA registered · Tasigna

    TGA label narrower than the PBS population

  2. Mar 2008
    Recommended · restricted

    vs dasatinib 70 mg twice daily and high-dose imatinib (600 to…

  3. Jul 2011
    Recommended

    Comparator changed: dasatinib 70 mg twice daily and high-dose imatinib (600 to 800 mg per…

  4. PBS listing · Authority Required
RecommendedDeferredNot recommended

Cost-effectiveness

Cost-minimisation analysis performed; no ICER calculated as no statistically significant difference in overall survival demonstrated between nilotinib and imatinib

The PBAC noted that the costs of monitoring liver function tests and electrocardiogram monitoring, (which is recommended prior to commencement of treatment with nilotinib and after seven days of treatment), were not included in the cost-minimisation analysis. The PBAC considered that these costs should be included. PBAC · 2011
Economic model disputed

Decision context

PopulationAdults with newly diagnosed Philadelphia chromosome positive chronic myeloid leukaemia in the chronic phase

Submission history

2 entries
DecidedOutcomeComparatorICEREvidence
Jul 2011 Recommended imatinib 400 mg once daily RCT · MMR
Mar 2008 Recommended · restricted dasatinib 70 mg twice daily and high-dose imatinib (600 to 800 mg per day) Single-arm · ORR

Similar precedents

By decision profile

Regulatory · TGA

Label narrower than PBS population — PBAC restricts to second-line use after imatinib/dasatinib failure; TGA label permits use after any prior therapy including imatinib.