Pharmac Shares Update On Its Assessment Of Trikafta

Pharmac has today published the latest record of advice from its Pharmacology and Therapeutics Advisory Committee (PTAC) and, for the first time, has published a summary of how Pharmac has assessed Trikafta.

“Trikafta is a medicine we would like to fund, we have two proposals for it on our Options for Investment (OFI) list for two different age groups, one for those 6 years and over and one for those 12 years and over,” says director of operations Lisa Williams. “We now have recommendations from both our Respiratory Advisory Committee and from PTAC that the medicine should be funded for people 6 years and over.”

“Since Trikafta was last considered by PTAC in November 2021 Pharmac has received more evidence from the supplier, Vertex, as well as information from consumer groups and healthcare practitioners. In April the Respiratory Advisory Committee reviewed the evidence and information and reiterated its recommendation to fund Trikafta for people 6 years and over with high priority. The Respiratory Advisory Committee also addressed some of PTAC’s concerns about the lack of longer-term evidence for the use of Trikafta in people aged less than 12 years. PTAC previously deferred making a recommendation for people 6 years and over but, following consideration of the new evidence and information in May 2022, has now recommended funding for them with medium priority.”

“Pharmac uses the recommendations from our clinical experts and evidence provided by the supplier and other interested people and groups to feed into our assessment and our work to determine where the application is ranked against other medicines.”

“Today we’re also releasing our Technology Assessment Report (TAR) for Trikafta. This is our health economic analysis, used to determine the cost-effectiveness of a medicine. We have published the Trikafta TAR as part of our goal to increase transparency so that people who are interested can see all the information we have considered. To support the public’s understanding of Pharmac’s full assessment of Trikafta, we have also created a summary to explain how we have considered the medicine using our Factors for Consideration.”

“Our assessment is that, if Trikafta were funded, there would be some savings to the health system through the reduction of the need for hospitalisations, lung transplants and supportive care. We also estimate that Trikafta could give people with cystic fibrosis who are aged 6 and over a longer and improved quality of life – specifically benefits equivalent to 27 more years at full health when compared to current funded treatments.”

“We don’t just look at how much, in dollar terms, a medicine costs, we also consider the health benefits to the person taking the medicine and what the benefits would be to the healthcare system. We know that there are also benefits from funding Trikafta that are not identified in our TAR, such as the health benefits for whānau and caregivers of people with cystic fibrosis. We consider these matters by using all our Factors for Consideration when we assess and prioritise medicines for funding,” says Ms Williams.

“It is very important we hear and listen to the voices of people directly affected when assessing a medicine like Trikafta. Hearing from them, alongside clinical evidence, helps us to understand the impact funding Trikafta would have. As we’ve seen with the positive recommendation from PTAC, it is encouraging and reinforces that it continues to be a medicine we want to fund.”

Pharmac has already re-ranked Trikafta on its OFI list having considered the updated advice from its clinical experts and is continuing commercial discussions with the supplier to try to reach an agreement that would enable the funding of Trikafta.

“Currently, there are 118 proposals on our OFI list for 75 different treatments, all of which would benefit New Zealanders if funded. Pharmac operates on a fixed budget, so we need to make difficult decisions about how to spend any available funding. This is why using our Factors for Consideration to rank and compare treatments on our OFI list is incredibly important. The Government announced a significant budget uplift to the pharmaceutical budget for this year and next, so we’re doing our very best to fund as many items on the OFI list that we can,” concludes Ms Williams.

Learn more

• Summary of the Technical Assessment Report
• Full Technical Assessment Report. 
  We have redacted parts of the report, in the interest of commercial confidentiality
• Record of PTAC's meeting May 2022
• Interim excerpt of the Respiratory Advisory Committee meeting April 2022

Pharmac processes and documents:

• Health economic assessments
• Options for Investment list
• Factors for Consideration
• Prioritisation

Trikafta is the brand name for this medicine. The medicine is a combination of three different chemicals: elexacaftor, texacaftor, and ivacaftor.
 

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