Australian patients with multiple myeloma face critical shortcomings in genetic testing at diagnosis and access to new ‘standard of care’ treatments such as daratumumab, a leading haematologist has told a Parliamentary inquiry.
Professor Andrew Spencer of Monash University says the current reimbursement model is unsuited to handling applications for the latest multi-agent anti-cancer treatments and the genetic tests that guide their use.
In a submission to the House of Representatives Inquiry into approval processes for new drugs and novel medical technologies in Australia he says recent findings from the Myeloma and Related Diseases Registry (MRDR) show that only about half of newly-diagnosed patients undergo chromosome testing.
The submission, made on behalf of the MRDR, notes that more than 80% of patients are still treated with therapies based on the proteasome inhibitor bortezomib despite significant variation in disease biology and prognosis.
MRDR data also show that 23% of newly diagnosed Australian MM patients will be ‘early progressors’, relapsing within 12 months and most failing to respond to second line salvage treatment.
Professor Spencer says the Australian approval and reimbursement model contrasts with many other countries where patients with MM now have access to new and highly active anti-MM therapies such as elotuzumab, daratumumab, isatuximab, panobinostat, ixazomib, selinexor and belantamab.
He acknowledges that daratumumab recently gained a positive recommendation for PBS listing from the PBAC, but even this move is described as only applying to a restricted group of MM patients, and with no certainty as to when it will actually be listed on the PBS.