In Australia, patients and government at odds over mesothelioma treatment costs

Our plain-English summary of In Australia, patients and government at odds over mesothelioma treatment costs, by V. Burkitt (Journal of the National Cancer Institute, 2007).

The study

• Author: V. Burkitt
• Journal: Journal of the National Cancer Institute
• Published: 2007;99(23):1750-2
• Type of article: News
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a news article, not a research study. The author reported on a dispute in Australia over public funding of pemetrexed, a chemotherapy drug given with cisplatin for mesothelioma. Australia's Pharmaceutical Benefits Advisory Committee (PBAC) had twice rejected listing pemetrexed for mesothelioma because of unacceptable cost-effectiveness, although it had approved the combination for non-small-cell lung cancer. A six-cycle course cost 20,000 to 25,000 Australian dollars. The article reported that access to the drug varied by state. A report commissioned by the Asbestos Diseases Foundation of Australia and the manufacturer Eli Lilly estimated that between 35% and 50% of patients could not get the treatment. As the journal went to press, the PBAC reversed its decision. This followed Eli Lilly showing that most patients tolerate the drug, cutting the price by 10%, and offering a lower 100 mg dose. The article also described cost-based decisions in England and Wales and in Canada. It also summarized a 2006 Journal of Thoracic Oncology review. The findings of that review belong to the review, not to this article.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: news article (journalistic report, not original research)
• Who was studied: Mesothelioma patients in Australia and the drug-funding decisions of Australia's Pharmaceutical Benefits Advisory Committee, with comparisons to England and Wales and to Canada; 2007
• Exposure: No asbestos exposure was studied; the article concerns access to and cost of pemetrexed in combination with cisplatin for mesothelioma
• Main results:
  • The PBAC had twice rejected pemetrexed for listing on the pharmaceutical benefits scheme
  • Earlier submissions were rejected because of unacceptable cost-effectiveness
  • A six-cycle course of pemetrexed with cisplatin cost 20,000 to 25,000 Australian dollars (US$18,383 to $22,979)
  • Access depended on location: patients in Western Australia were guaranteed treatment, while in New South Wales it was limited to people exposed to asbestos on the job
  • A report commissioned by the Asbestos Diseases Foundation and Eli Lilly estimated that between 35% and 50% of patients could not get pemetrexed combination chemotherapy
  • As the journal went to press, the PBAC overturned its previous decisions. This came after Eli Lilly showed the drug is tolerated by most patients, dropped its price by 10%, and offered a lower dose (100 mg versus 500 mg)
• The authors' conclusion: The article draws no scientific conclusion. It reports that after three reviews in three years, Australian mesothelioma patients would soon get subsidized access to pemetrexed

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Raltitrexed plus cisplatin is cost-effective compared with pemetrexed plus cisplatin in patients with malignant pleural mesothelioma — B. Woods, N. Paracha, et al. (2012)
• Systemic treatment of malignant pleural mesothelioma — F. Grosso, G.V. Scagliotti (2012)
• Future developments in the management of malignant pleural mesothelioma — P.A. Zucali, F. De Vincenzo, et al. (2009)
• Cost-effectiveness analysis of additional bevacizumab to pemetrexed plus cisplatin for malignant pleural mesothelioma based on the MAPS trial — M. Zhan, H. Zheng, et al. (2017)
• Antimetabolites in the treatment of advanced pleural mesothelioma: a network meta-analysis of randomized clinical trials — D. Tassinari, C. Cherubini, et al. (2017)
• Peritonectomy and hyperthermic intraperitoneal chemotherapy: cost analysis and sustainability — P.F. Bagnoli, F.C. Cananzi, et al. (2015)

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