Avelumab for Merkel cell carcinoma: 24 month predicted versus actual analysis, February 2022
Page last updated: 4 July 2022
Drug utilisation sub-committee (DUSC)
February 2022
Abstract
Purpose
Analysis of the predicted versus actual utilisation of avelumab 24 months following its addition to the Pharmaceutical Benefits Scheme (PBS) for the treatment of metastatic Merkel cell carcinoma (MCC) on 1 May 2019.
Data Source / methodology
PBS dispensing data for avelumab was extracted from the PBS data maintained by the Department of Health, processed by Services Australia. This data was used to establish the number of prevalent and incident patients utilising avelumab for Merkel cell carcinoma and time on therapy.
Key Findings
- In the first three years of listing there were 182, 235 and 244 prevalent patients per year since May 2019 to the data cut-off to 30 November 2021.
- Since listing, avelumab has had a steady increase in utilisation with up to 20 newly initiating patients per month and a prevalent patient population that does not appear to have plateaued.
- The number of prevalent patients per year was underestimated in years 2 and 3 while the number of prescriptions per year was overestimated.
- The number of Initial Authority STREAMLINED prescriptions was less than estimated in the first two years of listing while the number of Continuing prescriptions was considerably less than estimated in all three years of listing. However this may be due to only the availability of part year data in years 1 and 3.
- The number of males undergoing treatment with avelumab was over three times greater than females in 2020.
- The median age of patients initiating in 2020 was 79 years old in females and 77 years old in males.
- In the first month following listing, 38 patients who initiated on avelumab appeared to use previous therapies for MCC and there continues to be a small number of patients initiating per month with a previous history of other therapies. The median age in this group of patients was 72 years.
- The PBAC in July 2018 considered time on treatment to be an area of uncertainty. The submission estimated xxxxx of patients would continue treatment into the second year. The Kaplan-Meier analysis in this report indicates that the median time on treatment for patients was 304 days with breaks in supply or 248 days without breaks.
