PBAC's latest decision on Ticagrelor: Not recommended (2023). Considered for Treatment of acute coronary syndrome (ACS) in combination with aspirin for the prevention of atherothrombotic events (cardiovascular death, myocardial infarction and stroke) in adult patients.
PBAC outcome
Not recommended
Authority Required
ICER (AUD/QALY)
Not modelled
no economic evaluation
Submissions
2
first 2011
Submissions
2
2011 → 2023
Eligible population
Adult patients with acute coronary syndromes (unstable angina, non-ST elevation myocardial infarction, or ST elevation myocardial infarction) treated in combination with aspirin.
Therapy area
Cardiovascular
Line of therapy
Not applicable
Evidence base
Not applicable
Comparator
clopidogrel
Economic model
Not modelled
ICER note
This is a Category 3 submission (change to restriction level) with no new economic evaluation; no ICER calculated or presented.
ICER (historical)
$15k/QALY–$45k/QALY in an earlier submission (2011) — the latest submission carried no numeric base case. No single PSD states this combined range; see source PSDs.
Risk sharing
Risk-sharing arrangement in place — Ticagrelor was previously subject to a Deed of Agreement with a Risk Sharing Arrangement encompassing subsidisation caps; the Deed was terminated in 2017 following the end of the nominal Deed Term.
Why PBAC said no
Reasons cited in the latest PSD: Unreasonable assumption of nil financial impact; disparity in price between clopidogrel and ticagrelor would result in costs to the Commonwealth if uptake increased; no additional clinical benefits from unrestricting; prescriber confusion claim disagreed with by PBAC; inappropriate comparator nominated.