Nivolumab as adjuvant treatment of melanoma: 24 month predicted versus actual analysis and melanoma market review, September 2022
Page last updated: 31 March 2023
Drug utilisation sub-committee (DUSC)
September 2022
Abstract
Purpose
Analysis of the predicted versus actual utilisation of nivolumab 24 months following its addition to the Pharmaceutical Benefits Scheme (PBS) for the adjuvant treatment of melanoma on 1 March 2020. A broad market review of all medicines used in the treatment of melanoma was also undertaken.
Data Source / methodology
PBS dispensing data was extracted from the PBS data maintained by the Department of Health and Aged Care, processed by Services Australia.
Key Findings
- In the first year of listing adjuvant nivolumab was utilised by 1,311 patients at a cost of $75 million (based on published prices) to the PBS/RPBS which was xxxx than predicted.
- In the second year of listing adjuvant nivolumab was utilised by 1,120 patients at a cost of $62 million (based on published prices) to the PBS/RPBS which was xxxx than predicted.
- Patients initiating on adjuvant nivolumab ranged between 140-190 new patients per quarter.
- The majority of patients beginning adjuvant nivolumab were males (1,495 since listing) with a median age of 68 years, while females numbered less (719 since listing) with a median age of 66 years.
- Rate of prescribing of adjuvant nivolumab was as expected with capital cities and Queensland being the primary locations.
- Median time on treatment for adjuvant nivolumab was 231 days with breaks and 211 days without breaks.
- Approximately 75% of supplies of adjuvant nivolumab were at 480 mg every four weeks, 20% 240 mg and 5% was dose reductions or dose by weight.
- The utilisation and expenditure of nivolumab and ipilimumab have increased considerably since restrictions were changed in 2018 and 2019 regarding use in the unresectable setting.
- Based on published prices, total expenditure for melanoma medications in 2021 was approximately $500 million with the majority of costs incurred by checkpoint inhibitors in the unresectable market followed by PD1 inhibitors in the adjuvant market and BRAF/MEK inhibitors in the unresectable market.
