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Table 1 HTA recommendations issued between 2007 and 2011 for orphan drug technologies by AHTAPol.

From: Potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement process of orphan drugs

No.

Brand name (active substance)

Indication

HTA guidance

Reason for HTA recommendation

1

Fabrazyme (Agalsidase beta)

Fabry disease (alpha-galactosidase A deficiency) – long-term replace therapy

Negative

Insufficient clinical effectiveness, safety concerns, not cost-effective vs standard of care

2

Elaprase (Idursulfase)

Mucopolysaccharidosis type II, MPS II (Hunter syndrome) – long-term treatment

Negative

Insufficient clinical effectiveness

3

Kuvan (Tetrahydrobiopterin)

Hyperphenylalaninemia (HPA) in patients with tetrahydrobiopterin (BH4) deficiency

Positive

Restricted with time limits

4

Increlex (Mecasermin)

Insulin-like growth factor deficiency -IGFD (Laron Syndrome) – long-term treatment

Positive

Restricted with time limits

5

Somavert (Pegvisomant)

Acromegaly

Negative

Insufficient clinical effectiveness, not cost-effective vs standard of care

6

Ventavis (Iloprost)

Pulmonary arterial hypertension (PAH)

Positive

Restricted to subpopulations

7

Tracleer (Bosentan)

Pulmonary arterial hypertension (PAH)

Positive

Restricted to subpopulations

8

Cystadane (Betaine anhydrous)

Homocystinuria

Positive

Unrestricted

9

Zavesca (Miglustat)

Niemann-Pick type C syndrome (disease)

Positive

Restricted with time limits, conditional on the reduction of cost of therapy

10

Volibris (Ambrisentan)

Pulmonary arterial hypertension (PAH)

Positive

Unrestricted

11

Nexavar (Sorafenib)

Renal cell carcinoma (RCC)

Negative (2008)

Insufficient clinical effectiveness, not cost-effective vs standard of care, unacceptable budget impact

12

Nexavar (Sorafenib)

Renal cell carcinoma (RCC)

Negative (2009)

Not cost-effective vs standard of care, unacceptable budget impact

13

Nexavar (Sorafenib)

Hepatocellular carcinoma (HCC)

Positive

Restricted to subpopulations

14

Nplate (Romiplostim)

Chronic immune (idiopathic) thrombocytopenic purpura (ITP)

Positive

Restricted to subpopulations

15

Torisel (Temsirolimus)

Renal cell carcinoma (RCC)

Negative

Insufficient clinical effectiveness, not cost-effective vs standard of care

16

Tasigna (Nilotinib)

Chronic myeloid leukemia (CML)

Positive

Restricted to subpopulations, conditional on the reduction of cost of therapy

17

Vidaza (Azacitidine)

Acute myelogenous leukemia (AML)

Positive

Unrestricted

18

Glivec (imatinib)

Philadelphia chromosome positive chronic myeloid leukemia (ALL Ph+)

Positive

Unrestricted

19

Glivec (imatinib)

Myelodysplastic/myeloproliferative diseases (MDS/MPD)

Positive

Unrestricted

20

Glivec (imatinib)

Dermatofibrosarcoma protuberans (DFSP)

Positive

Unrestricted

21

Glivec (imatinib)

Malignant gastrointestinal stromal tumors (GIST)

Positive

Unrestricted

22

Revlimid (Lenalidomide)

Multiple myeloma (MM)

Positive

Restricted to subpopulations

23

Revlimid (Lenalidomide)

Myelodysplastic/Myeloproliferative syndrome (MM/S) (off-label indication)

Positive

Off-label indication, restricted to subpopulations, conditional on the reduction of cost of therapy

24

Yondelis (Trabectedin)

Soft tissue sarcoma

Positive

Restricted to subpopulations, conditional on the reduction of cost of therapy

25

Sprycel (Dasatinib)

Chronic myeloid leukemia (CML)

Positive

Restricted to subpopulations

26

Revatio (Sildenafil)

Pulmonary arterial hypertension (PAH)

Positive

Unrestricted

27

Atriance (Nelarabine)

T-cell acute lymphoblastic leukemia

Positive

Restricted to subpopulations, conditional on the reduction of cost of therapy