Pemetrexed DisodiumPemetrexed SUN
First-line treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) with predominantly non-squamous cell histology in combination with cisplatin.
Decisions on record
- Meeting Mar 2010 Not recommended Cancer treatment
- Meeting Nov 2009 Deferred Anti-cancer drug
- Meeting Mar 2009 Recommended Anticancer drug
- Meeting Mar 2008 Recommended Cancer no PSD
- Meeting Nov 2007 Recommended Cancer
Access path
- TGA registered · Pemetrexed SUN
TGA label narrower than the PBS population
- Nov 2005Recommended
vs cisplatin
- Nov 2005Recommended
- Nov 2007Recommended · restricted
Comparator changed: cisplatin → cisplatin monotherapy
- Nov 2009Recommended · restricted
ICER dropped $105,000 → $45,000 (-57%)
- PBS listing · Authority Required
Cost-effectiveness
The PBAC considered that the ICER between $15,000 - $45,000 /QALY in the model is acceptable, however, is high given the magnitude of the clinical benefit (0.9 months median overall survival time). PBAC · 2009
Decision context
PopulationAdults with locally advanced or metastatic non-small cell lung cancer (Stage IIIB and Stage IV) with predominantly non-squamous cell histology (adenocarcinoma, large cell carcinoma, and other NSCLC histologies with <10% squamous component), treatment-naïve, to receive pemetrexed in combination with cisplatin.
Submission history
| Decided | Outcome | Comparator | ICER | Evidence |
|---|---|---|---|---|
| Nov 2009 | Recommended · restricted | gemcitabine in combination with cisplatin | $15k–45k | RCT · OS |
| Nov 2007 | Recommended · restricted | cisplatin monotherapy | $45k–105k | RCT · OS |
| Nov 2005 | Recommended | cisplatin | $45k–105k | RCT · OS |
| Nov 2005 | Recommended | cisplatin | $45k–105k | RCT · OS |
Similar precedents
Regulatory · TGA
Label narrower than PBS population — PBAC restricts to un-resectable locally advanced or metastatic mesothelioma; TGA label includes both mesothelioma and NSCLC post-platinum.