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BCNA News 16 Jan 2020

Abemaciclib listed for first-line treatment on PBS

Breast Cancer Network Australia (BCNA) has welcomed the addition of the CDK inhibitor abemaciclib (Verzenio) on the Pharmaceutical Benefits Scheme (PBS).

It has been added as first-line treatment for ‘non-premenopausal’ people newly diagnosed with hormone receptor positive, HER2-negative metastatic breast cancer. The listing took effect on 1 January 2020.

Abemaciclib is the third CDK inhibitor to be listed on the PBS for first-line treatment, along with ribociclib (Kisqali) and palbociclib (Ibrance). All are used to treat people newly diagnosed with hormone receptor positive, HER2-negative metastatic breast cancer. They are oral medications given with a hormone blocking therapy, such as letrozole, to slow the spread of disease.

While abemaciclib is in the same family of drugs as ribociclib and palbociclib, it has a different structural make up so has different side effects. While ribociclib and palbociclib are not recommended for women with, or at risk of developing, some heart conditions, abemaciclib does not cause cardiac issues so is a good option for people with heart problems.

Abemaciclib is also less likely than the other CDK inhibitors to cause neutropenia (a low white blood cell count).

Another benefit of abemaciclib is that it is a smaller molecule and more likely to cross the blood brain barrier than the other two CDK inhibitors. It may be more effective in preventing and/or treating brain metastases.

Second and later-line treatment

While the listing of abemaciclib on the PBS for first-line treatment is good news, BCNA is aware there are many people with metastatic breast cancer who would like to use these drugs as a second, or later-line, treatment.

To date, none of the three pharmaceutical companies that produce the CDK inhibitors has made an application to have the drugs listed for later-line treatment. Drugs cannot be added to the PBS until they have undergone a rigorous approval process. The first stage is an application by the company that owns or distributes the drug in Australia.

BCNA is working with the drug companies and other stakeholders in an attempt to have one or more of the CDK inhibitors subsidised for later-line treatment. We will keep you updated via our website and other communication channels.

Currently, the only options for people wishing to use a CDK inhibitor for later-line treatment are to pay the full price (approximately $5,000 per month) or apply to one of the pharmaceutical companies for access through a patient access program.

Pfizer is currently running a patient access program for palbociclib. There is a significant co-payment required however, with patients having to pay for the first eight packs, at a cost of $4,850 per pack plus any pharmacy dispensing fees. Following this, Pfizer will provide palbociclib at no charge for as long as the treatment is shown to be clinically benefitting you.

If you are interested in paying for a CDK inhibitor for later-line treatment, or seeing if you are eligible for a patient access program, you should talk to your medical oncologist.

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