AMIVANTAMAB

The PBAC recommended the listing of amivantamab, in combination with platinum-based doublet chemotherapy (PDC), for the treatment of patients with epidermal growth factor receptor gene mutated (EGFRm) locally advanced/metastatic non-small cell lung cancer (NSCLC), where the condition has progressed during or after treatment with osimertinib, a medicine commonly used for patients with EGFRm NSCLC. 

The PBAC welcomed input from individuals, health care professionals and organisations. Input from individuals expressed hope that amivantamab could improve quality of life and prolong survival noting that there were significant negative side-effects such as lethargy, pain, difficulty breathing and reduced mobility associated with currently available treatment options. Input from health care professionals indicated that amivantamab would provide meaningful benefits for patients, helping people live longer and slowing the progression of their disease.

The PBAC considered that the patient population most likely to be treated with amivantamab would have similar characteristics (patients who are otherwise well but whose cancer is widespread) to the patient population that is currently treated with atezolizumab plus bevacizumab with carboplatin and paclitaxel (ABCP), a currently available treatment option. 

The PBAC considered that based on the clinical evidence presented in the submission, amivantamab in combination with PDC was more effective than a currently available treatment option of PDC alone. The PBAC considered the benefit was modest and was associated with increased adverse events. 

However, the PBAC noted there was not enough clinical data available to determine whether amivantamab in combination with PDC provides additional benefit to patients compared with the existing treatment ABCP.  In this context, the PBAC considered that amivantamab for the treatment of EGFRm patients would be cost-effective if its price was based on the price of atezolizumab plus bevacizumab for the treatment of patients with non-squamous NSCLC, which includes patients with EGFRm. The PBAC considered amivantamab would be cost effective with a cost per 3-week treatment cycle no higher than that for atezolizumab plus bevacizumab. The PBAC considered the estimated number of patients who would be eligible for treatment with amivantamab presented in the submission was reasonable, but the submission overestimated the number of patients who would use the medicine.