Background: On-going research has shown that immunotherapies have significantly improved survival outcomes in several oncology indications. Most oncology patients in Australia cannot access these medications until they receive national reimbursement through the PBS. Therefore, the objective of this study is to examine the effects of different reimbursement timelines of PD-1/PD-L1 inhibitors on the health outcomes of cancer patients in Australia.
Methods: The Health Impact Projection model estimates the key clinical outcomes of patients receiving PD-1/PD-L1 inhibitors compared to standard of care over five years. Six high‐incidence cancers were assessed: melanoma, first and second line NSCLC, urothelial, head and neck and renal cell carcinoma.
Three reimbursement scenarios were considered. The base case scenario represents the actual reimbursement timelines for each indication. The other two scenarios represent alternate scenarios where the base case timelines are either accelerated to 9 months or delayed by 12 months. An additional scenario was conducted to assess the clinical outcomes gained due to the special PBAC meeting to consider a broad PBS listing for PD-1/PD-L1 inhibitors for NSCLC.
Results: Relative to the base scenario, the analysis showed that delayed access resulted in a decrease of 3,448 life years, 5,028 progression-free years and an increase of 890 grade 3‐5 adverse events in the population. In contrast to delayed reimbursement, accelerated reimbursement leads to an 18.8% increase in life years, 22.0% increase in progression-free years, and the avoidance of 5.9% more adverse events. Crucially, accelerated reimbursement opens access for 3,995 more patients to be treated over the 5-year time horizon, whereas delayed reimbursement restricts access for 5,338 patients, relative to the base case.
Conclusions: The time for drugs to receive national reimbursement has a significant impact on clinical health outcomes for Australian patients. This research highlights the importance of policy work to provide faster access to innovative life‐saving treatments.