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  • Icatibant For Hereditary Angioedema 2015 06 Prd

Icatibant: 24 month predicted versus actual analysis

Page last updated: 30 October 2015

Drug utilisation sub-committee (DUSC)

June 2015

Abstract

Purpose

To compare the predicted and actual utilisation of icatibant during the first 24 months of PBS listing (1 August 2012 to 31 July 2014).  At its February 2015 meeting, the DUSC requested that the report include analysis of the number of prescriptions per patient, as the number of attacks per patient and the proportion of these that are of a high enough severity to justify the use of icatibant was considered to be highly variable and unpredictable at the time of listing.

Date of listing on the Pharmaceutical Benefits Scheme (PBS)

Icatibant was listed on the PBS on 1 August 2012.

Data Source / methodology

  • PBS pharmacy claims data from the Department of Human Services (DHS) prescription database.

Key Findings

  • The number of patients supplied icatibant has been much lower than expected (''''' % of expected). This is probably due to an overestimate of number of people with hereditary angioedema (HAE) as epidemiological data was limited at the time of listing. Alternatively, uptake may be lower than expected, but this is unlikely as clinicians advised that all patients diagnosed with HAE should be supplied icatibant.
  • The number of injections supplied per patient is higher than predicted, at approximately '''''''''''''' that predicted in year 2.  This could be due to;
    • use for cutaneous attacks;
    • use for mild symptoms of non-cutaneous attacks;
    • patients having supplies on hand;
    • expiry of icatibant for patients with infrequent attacks;
    • patients experiencing more attacks with moderate to severe symptoms than
      anticipated;
    • a higher than expected rate of treatment of moderate to severe attacks; and/or
    • on average, a higher number of injections per attack;
  • The base case economic model accepted by the PBAC included 3.25 treated attacks per year (ICER of $45,000 to $75,000/QALY) with a sensitivity analysis of ''''''''' treated attacks per year (ICER of $75,000 to $105,000 /QALY, includes treatment of '''''% of cutaneous attacks).

Full Report