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Media release
 
Brain tumour patients and PBAC decision
 
The decision by the Pharmaceutical Benefits Advisory Committee (PBAC) not to recommend the subsidisation of Avastin (bevacizumab) for recurrent glioma brain tumour patients is unfortunate, Denis Strangman, Secretary of the patient support group Brain Tumour Alliance Australia (BTAA), said today. (See here for PBAC decision: http://www.health.gov.au/internet/main/publishing.nsf/Content/pbacrec-nov10-first-time-rejections )
 
The PBAC has made its decision on the basis of ‘uncertain clinical benefit and an unacceptably high and uncertain incremental cost-effectiveness ratio’.
 
In a submission to the PBAC prior to its evaluation BTAA supported subsidisation because there is very little else on offer to patients whose malignant primary brain tumour progresses after standard therapy. At the same time we expressed our wish that the Roche company’s patient access scheme should be more generous.
 
We understand that the Roche Company, despite this negative decision, will continue its patient access scheme and will continue its dialogue with the PBAC. Both these decisions are good news for patients although BTAA repeats its request for the access scheme to be more generous.
 
There has been a major debate about the role and effectiveness of Avastin for brain tumour patients but brain tumour patients do not have the luxury of waiting around for these debates to be finalised. There are about 1600 patients each year in Australia who are diagnosed with the type of brain tumour for which Avasin, on recurrence, might be appropriate.
 
In the USA the equivalent body, the FDA, has approved it for this same indication but the European equivalent regulatory agency has not. This has complicated the situation.
 
The therapy is particularly relevant for those diagnosed with the most lethal of the primary malignant brain tumours glioblastoma multiforme grade IV, which is what Professor Chris OBrien and the late Senator Edward Kennedy both had. People diagnosed with this tumour have very few treatment options.
 
At an international brain tumour scientific conference which I attended in Montreal last month there was spirited discussion about Avastin and there is growing evidence that it has a beneficial effect on quality of life and a reduction in brain swelling and as a steroid replacement.

The problem is that the regulatory authorities are constrained by evaluation formulae which do not fully evaluate the broader effectiveness of some of these new therapies. For a brain tumour patient with this kind of disease even a few months survival with a reasonable quality of life is better than an early death but the evaluation formulae tends to focus on overall survival, Mr Strangman said.
 
Denis Strangman
Secretary BTAA
www.btaa.org.au
Wednesday 22 December 2010
Phone: 1800 857 221