The Drug Advisory Committee of Hong Kong's Hospital Authority reviewed 20 drugs in July, approving Boehringer Ingelheim's (Germany) Giotrif (afatinib) and Pfizer's (US) Eliquis (apixaban), but rejecting Eli Lilly's (US) Cymbalta.
IHS Life Sciences perspective | |
Significance | The Hong Kong Hospital Authority's Drug Advisory Committee (DAC) reviewed 20 drugs in July, approving nine, including Boehringer Ingelheim's (Germany) Giotrif (afatinib), and rejecting another nine, including Eli Lilly's (US) Cymbalta, with two decisions pending. |
Implications | Lack of detail on the indications under consideration makes it challenging to weigh up the key factors in the DAC's decision-making process. |
Outlook | Cost-effectiveness concerns and the availability of alternative treatments with comparable benefits on the Hospital Authority's drug formulary are the main reasons for rejecting the treatments. In only two cases – Johnson & Johnson's (US) Zytiga (abiterone) and Bayer's (Germany) Xofigo (radium-223 dichloride) – was the treatment also rejected due to unfavourable benchmarking with comparable reimbursement schemes. |
The Drug Advisory Committee (DAC) of Hong Kong's Hospital Authority (HA) reviewed 20 drugs in July, issuing nine approvals and nine rejections, with two pending a decision.
Hong Kong Hospital Authority's Drug Advisory Committee decisions (July) | |||
Drug | Company | Therapeutic class | Primary reason for rejection |
Approved | |||
Giotrif (afatinib) | Boehringer Ingelheim (Germany) | Malignant disease and immunosuppression | N/A |
Eylea (aflibercept) | Regeneron (US) | Eye | N/A |
Eliquis (apixaban) | Pfizer (US) | Cardiovascular system | N/A |
Avastin (bevacizumab) | Roche (Switzerland) | Malignant disease and immunosuppression | N/A |
Xalkori (crizotinib) | Pfizer | Malignant disease and immunosuppression | N/A |
Forxiga (dapagliflozin) | AstraZeneca (UK) | Endocrine system | N/A |
Complera (emtricitabine + rilpivirine + tenofovir) | Gilead Sciences (US) | Infections | N/A |
Anoro Ellipta (umeclidinium + vilanterol) | GlaxoSmithKline (UK) | Respiratory system | N/A |
Taflotan (tafluprost) | Santen (Japan) | Eye | N/A |
Pending | |||
Zarzio (filgrastim) | Novartis (Switzerland) | Nutrition and blood | |
Perjeta (pertuzumab) | Roche | Malignant disease and immunosuppression | |
Rejected | |||
Zytiga (abiterone) | J&J (US) | Malignant disease and immunosuppression | The justification of the treatment's cost in relation to its benefits is insufficient. Unfavourable benchmark with comparable national reimbursement schemes. |
Tivicay (dolutegravir) | ViiV (US) | Infections | Alternative(s) available in HA drug formulary with comparable benefits. |
Cymbalta (duloxetine) | Eli Lilly (US) | Central nervous system | Alternative(s) available in HA drug formulary with comparable benefits. |
Sancuso (granisetron) | ProStrakan (UK) | Central nervous system | Alternative(s) available in HA drug formulary with comparable benefits |
Lignopad (lidocaine 5% medicated) | Teikoku Seiyaku (Japan) | Anaesthesia | Alternative(s) available in HA drug formulary with comparable benefits. |
Nebilet (nebivolol) | Menarini (Italy) | Cardiovascular system | Alternative(s) available in HA drug formulary with comparable benefits. |
Xolair (omalizumab) | Roche | Respiratory system | The justification of the treatment's cost in relation to its benefits is insufficient. |
Xofigo (radium-223 dichloride) | Bayer (Germany) | Radiopharmaceuticals | The justification of the treatment's cost in relation to its benefits is insufficient. Unfavourable benchmark with comparable national reimbursement schemes. |
Stivarga (regorafenib) | Bayer | Malignant disease and immunosuppression | The justification of the treatment's cost in relation to its benefits is insufficient. |
Source: Hospital Authority Drug Advisory Committee | |||
Outlook and implications
The lack of detail on the specific indications targeted by each drug under consideration means it is challenging to weigh up the key factors in the DAC's decision-making process. For example, Roche's (Switzerland) Perjeta (pertuzumab) had been rejected for the second consecutive time during the DAC's January meeting. However, the latest meeting shows that the drug is now "pending" a decision, although it is unclear for which indication.
Nevertheless, it is worth underlining that cost-effectiveness concerns and the availability of alternative treatments with comparable benefits on the HA's drug formulary are the main reasons for rejecting the treatments. In only two cases – John & Johnson's (US) Zytiga (abiterone) and Bayer's (Germany) Xofigo (radium-223 dichloride) – was the treatment also rejected due to unfavourable benchmarking with comparable reimbursement schemes.