Report on New Patented Drugs - Alimta



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Report on New Patented Drugs - Alimta Under its transparency initiative, the PMPRB publishes the results of the reviews of new patented drugs by Board Staff, for purposes of applying the PMPRB s Excessive Price Guidelines (Guidelines), for all new active substances introduced after January 1, 2002. Brand Name: Alimta Generic Name: (pemetrexed disodium ) DIN: 02253437 500 mg vial Patentee: Eli Lilly Canada Inc. Indication - as per product monograph: Date of Issuance of First Patent(s) Pertaining to the Medicine: July 25, 2000 Notice of Compliance: May 21, 2004 Date of First Sale: July 29, 2004 As first line therapy, Alimta is indicated in combination with cisplatin for the treatment of patients with malignant pleural mesothelioma (MPM) whose disease is unresectable or who are otherwise not candidates for curative surgery. ATC Class: L01BA04 Antineoplastic and Immunomodulating Agents Folic Acid Analogues APPLICATION OF THE GUIDELINES Summary The introductory price of Alimta 500 mg vial was found to be within the Guidelines because its price in Canada did not exceed the prices in the other comparator countries where Alimta 500 mg vial was sold. Although Alimta represents a category 3 new medicine under the Guidelines, it was not possible to identify comparator drug products for purposes of conducting a Therapeutic Class Comparison (TCC) test under the Guidelines, and therefore the median of the International Price Comparison (IPC) test was used in determining the maximum non-excessive (MNE) price of Alimta. Page 1 of 6

Scientific Review The PMPRB's Human Drug Advisory Panel (HDAP) recommended that Alimta be classified as a category 3 new medicine (provides moderate, little or no therapeutic advantage over comparable medicines). The HDAP further recommended that, as there is no standard therapy for the treatment of MPM, and since no comparative clinical studies on combination therapies are available, it was not possible to identify comparator drug products for purposes of conducting a TCC test under the Guidelines. Price Review Under the Guidelines, in circumstances where it is not possible or appropriate to conduct a TCC test for a new category 3 drug product, the MNE price is determined with reference to the median of the prices of the same medicine in the seven countries listed in the Patented Medicines Regulations, 1994 (Regulations). The price of Alimta 500 mg vial was within the Guidelines in the first 30-day sales of the medicine from July 29, 2004, as its price in Canada did not exceed the price of Alimta 500 mg vial in the only other country in which it was then sold, the United States. Alimta 500 mg vial was subsequently introduced for sale in two other countries listed in the Regulations during the last months of 2004 (Germany and Sweden). The following table identifies the prices of Alimta 500 mg vial in relation to those countries in which it was then sold: Country Price per vial (CDN$) Canada $2750.0000 Germany $2163.8000 Sweden $2145.4800 United States $2865.1400 International Median $2163.8000 Source: Publicly available prices as per the Patented Medicines Regulations, 1994. Page 2 of 6

In 2005, when Alimta 500 mg vial was sold in all of the seven countries listed in the Regulations, its price in Canada did not exceed the median price of those countries, and was therefore within the Guidelines. The following table sets out the prices of Alimta 500 mg vial in relation to the other listed countries: Country Price per vial (CDN$) Canada $2,115.6900 Germany $2,295.8600 Sweden $2,289.6800 France $1,907.9100 Italy $2,297.4500 Switzerland $2,239.4600 United Kingdom $1,880.1500 United States $2,698.1200 International Median $2,289.6800 Source: Publicly available prices as per the Patented Medicine Regulations, 1994. Where comparators and dosage regimens are referred to in the Summary Reports, they have been selected by the HDAP for the purpose of carrying out the PMPRB s regulatory mandate, which is to review the prices of patented medicines sold in Canada to ensure that such prices are not excessive. The publication of these reports is also part of the PMPRB s commitment to make its price review process more transparent. The information contained in the PMPRB s Summary Reports should not be relied upon for any purpose other than its stated purpose and is not to be interpreted as an endorsement, recommendation or approval of any drug nor is it intended to be relied upon as a substitute for seeking appropriate advice from a qualified health care practitioner. Page 3 of 6

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25. Tomek S, Emri S, Krejcy K, Manegold C. Chemotherapy for malignant pleural mesothelioma: past results and recent developments. Br J Cancer 2003;88:167-74. 26. Tomek S, Manegold C. Chemotherapy for malignant pleural mesothelioma: past results and recent developments. Lung Cancer 2004;45S (suppl):s103-119). 27. Van Meerbeeck JP, Manegold C, Gaafar R, et al. A randomized phase III study of cisplatin with or without raltitrexed in patients (pts) with malignant pleural mesothelioma (MPM): An intergroup study of the EORTC Lung Cancer Group and NCIC [abstract]. J Clin Oncol 2004;(14S):7021. Available from: http://www.asco.org/ac/1,1003,_12-002643-00_18-0026-00_19-001437,00.asp (accessed 10 Nov 2004). 28. Van Ruth S, Baas P, Zoetmulder FAN. Surgical treatment of malignant pleural mesothelioma: A review. CHEST 2004; 123:551-61. 29. Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of emetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 2003;21(14):2635-44. 30. Vogelzang NJ. Et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malinant pleural mesothelioma. J of Clin. Oncology: 21(14)2003;2636-2544. 31. Zellos LS, Sugarbaker DJ. Diffuse malignant mesothelioma of the pleural space and its management. Oncology 2002;16(7):907-13, 16-17, 19-20. Page 6 of 6