Will BMS's 'Revlimid' be reimbursed as RVd therapy?

Whether Revlimid will be reimbursed for RVd therapy receives attention

Expectations rise with PBAC review of the agenda… focus in on whether an alternative for elderly patients will finally be introduced to the field

RVd therapy improved PFS compared to Rd therapy in a Phase III trial

Whether the multiple myeloma treatment ‘Revlimid’ will succeed in expanding reimbursement to its use in RVd therapy is gaining attention.

 

According to industry sources, reimbursement of Revlimid (lenalidomide) for RVd therapy (Lenalidomide + bortezomib + dexamethasone) passed the Health Insurance Review and Assessment Services’ Cancer Disease Deliberation Committee review in September and is awaiting deliberation by the Pharmaceutical Benefits Appraisal Committee.

 

The agenda is expected to be presented for PBAC deliberation in December.

 

In Korea, the standard first-line therapy for multiple myeloma under reimbursement includes VMP (bortezomib+ melphalan+ prednisolone) and Rd (lenalidomie+dexamethasone) in patients who are not eligible for stem cell transplants, and VTd (bortezomib+thalidomide+dexamethasone) for patients eligible for stem cell transplants.

 

However, the 5-year relative survival rate of multiple myeloma patients in Korea remains in the 40% range.

 

RVD therapy is recommended as a priority in the first-line treatment of multiple myeloma in the US NCCN guidelines and EHA-ESMO guidelines.

 

According to HIRA, among the 8,929 patients in Korea who were treated for multiple myeloma in 2020 (diagnosis code: C90, multiple myeloma, and malignant plasma cell neoplasms), 47% were over the age of 70 and were ineligible for transplant under the reimbursement standards.

 

Elderly patients over the age of 70 have limited treatment options as they have difficulty receiving stem cell transplants, raising the demand for RVd reimbursement.

 

Seok-Jin Kim, Professor of Hematology-Oncology at the Samsung Medical Center, said, “Treatment of multiple myeloma requires multiple considerations from the medical aspect as well as in the patient’s condition, treatment sequence, reimbursement conditions, etc.

 

Both the patients and us HCPs will welcome a treatment option with a promising prognosis that can be used freely without reimbursement restrictions." He added, “I hope reimbursement for multiple myeloma treatments is extended to cover RVd therapy, maintenance therapy after autologous hematopoietic stem cell transplant, and R2 in follicular lymphoma to benefit more patients.” In a Phase III clinical trial, RVd therapy significantly extended PFS (progression-free survival) and OS (overall survival) compared to Rd therapy in patients with newly diagnosed multiple myeloma that are ineligible for stem cell transplant.

 

In a network meta-analysis that assessed the relative efficacy of MM drugs used in newly diagnosed patients that are ineligible for stem cell transplant, RVd demonstrated significant extension in PFS and OS over Rd, and Rd over VMP.