CADTH Reimbursement Review - Provisional Funding Algorithm - Indication: Multiple myeloma

This disclaimer and any questions or matters of any nature arising from or relating to the content or use (or misuse) of this document will be governed by and interpreted in accordance with the laws of the Province of Ontario and the laws of Canada applicable therein, and all proceedings shall be subject to the exclusive jurisdiction of the courts of the Province of Ontario, Canada. [...] Background The provisional funding algorithm process is used to provide advice when the drug programs have indicated that there is a need to establish an appropriate place in therapy for the drug under review relative to alternative treatments that are currently reimbursed by the drug programs, including the impact on the appropriate sequencing of treatments for the purposes of reimbursement. [...] In addition to the previously outlined advice, the panel indicated that because an improvement in cost-effectiveness was a condition for reimbursement in each of the recommendations related to the drugs in scope, implementation of any advice herein should be contingent upon ensuring that the relevant treatments are affordable to public payers. [...] Sequencing of Novel Therapies in the Relapsed or Refractory Setting, Considering Evidence and Affordability of Options To address this implementation issue, the panellists discussed the effectiveness of sequencing of novel triplet therapies containing at least 2 of the following: a proteasome inhibitor (PI), an immunomodulator, and an anti-CD38 antibody, all combined with dexamethasone. [...] Panellists indicated that with the coming funding of daratumumab triplets in the first-line setting, this would effectively reduce the number of available lines of novel drug therapy down to 2, and this would be a step backwards in the treatment of multiple myeloma, where 3 lines of therapy have been the standard for many years.