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SunitinibSunitinib Sandoz

Not recommended OncologyAuthority RequiredFirst-line line

Initial and continuing treatment of metastatic, unresectable, well-differentiated malignant pancreatic neuroendocrine tumour (pNET) in patients who are symptomatic despite somatostatin analogues or who have documented disease progression.

2
Submissions
2 resub
2012–13
On the record
$45k–75k
ICER range
2 sourced ICERs · 2012–2013
ICER stated
Cost basis
risk sharing

Decisions on record

3 decisions
  • Meeting Jul 2012 Not recommended Treatment of unresectable, well-differentiated pancreatic neuroendocrine tumours (pancreatic NET). Sunitinib is also registered for the treatment of advanced renal cell carcinoma and for the treatment of gastrointestinal stromal tumour after failure of imatinib mesylate treatment due to resistance o
  • Meeting Mar 2012 Deferred Anti-cancer drug
  • Meeting Jul 2011 Not recommended Anti-cancer drug

Access path

2 submissions · public record
  1. TGA registered · Sunitinib Sandoz

    TGA label narrower than the PBS population

  2. Jul 2012
    Recommended

    vs best supportive care (placebo)

  3. Aug 2013
    Recommended

    Comparator changed: best supportive care (placebo) → best supportive care/placebo

  4. PBS listing · Authority Required
RecommendedDeferredNot recommended

Cost-effectiveness

2 sourced ICERs · 2012–2013
The PBAC noted the value of the ICER for pNET was between the accepted ICERs for the RCC and GIST indications and considered that the proposed ICER for pNET was closer to that of RCC than for GIST. PBAC · 2013
ICER uncertainEconomic model disputedSurrogate endpointCost-effectiveness accepted

Decision context

PopulationAdults with metastatic or unresectable, well-differentiated malignant pancreatic neuroendocrine tumour (pNET) who are symptomatic despite somatostatin analogues or have documented disease progression.

Risk sharingThe sponsor offered to renegotiate the current risk share arrangement to include sunitinib for pNET.

Submission history

2 entries
DecidedOutcomeComparatorICEREvidence
Aug 2013 Recommended best supportive care/placebo $45k–75k RCT · OS
Jul 2012 Recommended best supportive care (placebo) $45k–75k RCT · PFS, OS

Similar precedents

By decision profile

Regulatory · TGA

Label narrower than PBS population — PBAC restricts to metastatic disease, symptomatic despite somatostatin analogues, or documented progression; TGA label includes all unresectable pancreatic NETs.