PHARMAC changes to advanced melanoma funding criteria approved - effective from 1 December 2019

November 20, 2019

The July CaTSoP meeting reviewed immune checkpoint inhibitors (nivolumab and pembrolizumab) for advanced melanoma. CaTSoP recommended several amendments be made to the current funding criteria for these agents.

The amendments can be summarised as follows:

1. Allow medical practitioners to make Special Authority applications (both initial and renewal) on the recommendation of a medical oncologist;
2. Remove the specified number of cycles in an approval period;
3. Exclude the treatment of new patients with uveal melanoma;
4. Facilitate more appropriate clinical management of patients with evaluable but not radiologically measurable disease;
5. Allow flexibility in the dose administration schedule; and
6. Allow retreatment for patients who had previously stopped funded treatment for reasons other than disease progression or toxicity.

As a result of this advice and feedback received through public consultation, PHARMAC are amending the funding criteria for nivolumab and pembrolizumab for advanced melanoma to implement the above six recommendations from 1 December 2019.

This document details amendments to the current criteria. The same changes are being made in Section B and Section H of the Pharmaceutical Schedule.