Interventions of Interest:
- Rucaparib (Rubraca®, Clovis Oncology)
- Niraparib (Zejula®, Tesaro, Inc.)
- Olaparib (Lynparza®, AstraZeneca)
ICER’s report reviews evidence on the comparative clinical effectiveness and value of poly (ADP-ribose) polymerase (PARP) inhibitors for treatment of ovarian cancer.
During the public meeting the Midwest CEPAC voted on key questions related to the clinical effectiveness and value of the PARP inhibitors in two key populations: women receiving maintenance therapy for recurrent disease that has previously responded to a platinum-based chemotherapy, and women being treated for recurrent disease who have a breast cancer (BRCA) gene mutation. The Council found evidence sufficient to show a greater net health benefit of niraparib (Zejula®, Tesaro, Inc.) in either population, and of olaparib (Lynparza®, AstraZeneca) as maintenance therapy. Votes were split on the net health benefit of olaparib and rucaparib (Rubraca®, Clovis Oncology) in treatment of recurrent disease.
Below you will find the final documents from the policy paper review process:
ICER’s Chief Scientific Officer Dan Ollendorf, PhD stated:
“Our report and meeting highlighted the need for further research on the long-term efficacy and safety of PARP inhibitors. In particular, information on improvement in overall survival is not yet available, and the trials of each agent differ in study population, design, and measurement of key outcomes. Some key studies involved no comparison to alternative treatments. Further, the high costs of the drugs do not align with their benefit to patients. Despite these shortcomings, PARP inhibitors are the first novel treatments available for ovarian cancer in many years, and do have the potential to improve upon existing treatment options for many patients. Stakeholders must collaborate to conduct additional research that provides more clarity on the appropriate clinical use of these drugs, and to ensure that the high costs do not lead to restricted access for patients with already limited options. Our hope is that the objective analyses provided in our report can serve as a starting point for critical conversations around future research, pricing, and access.”