PanitumumabVectibix

The PBAC recommended the first-line listing of panitumumab, for the treatment of RAS wild-type metastatic colorectal cancer, on the basis of cost minimisation with cetuximab. The equi-effective doses are panitumumab 6 mg/kg every two weeks and cetuximab 250 mg/m2 weekly, following an initial loading dose of 400 mg/m2. 3PSD · Mar 2015

The PBAC noted that, as a result, this listing would be cost neutral to the Commonwealth.PSD · Mar 2015

6.21 The re-submission presents modelled cost-utility analyses in RAS WT mCRC for comparisons of first-line panitumumab + FOLFOX with (1) bevacizumab + FOLFOX, (2) FOLFOX alone, and (3) a weighted combination of these comparators. This is consistent with the claims of superiority presented in the clinical evidence.PSD · Jul 2014

6.22 The re-submission did not present an economic evaluation of the other request in the re-submission to change the PBS eligibility criteria for panitumumab from KRAS WT to RAS WT. The ESC advised that such an evaluation would result in dominance for RAS WT because this would reduce the proportion of existing patients receiving additional panitumumab resulting in inferior health outcomes, and the increased costs of RAS testing would be outweighed by the …PSD · Jul 2014

6.19 For the first-line RAS WT mCRC population, the re-submission describes panitumumab + FOLFOX as:  superior in terms of comparative effectiveness and with “a different safety profile” compared to bevacizumab + FOLFOX; and  superior in terms of comparative effectiveness and which “adds a manageable level of toxicity” (or otherwise inferior in terms of comparative safety) over FOLFOX alone. 11PSD · Jul 2014

6.20 Each description about comparative effectiveness is supported by the respective randomised trial, however the addition of panitumumab to FOLFOX appears to have an inferior safety profile compared with the addition of bevacizumab to FOLFOX or compared with FOLFOX alone.PSD · Jul 2014