Daratumumab for multiple myeloma
About technology assessment reports (TARs) and Pharmac's consideration of daratumumab for multiple myeloma.
We understand that multiple myeloma and AL-amyloidosis have a significant impact on people’s lives. We’re continuing to talk with the supplier, Janssen, about its funding applications for daratumumab.
Earlier this year, our staff considered an updated proposal from Janssen. We reviewed our assessment of daratumumab and compared the updated proposal to other medicines we are considering for funding.
The ranking of the updated proposal for daratumumab, and the budget currently available to us, unfortunately means we are not able to fund daratumumab at this time. This does not prevent us from considering it for funding in the future.
We appreciate the strong advocacy of consumer groups on behalf of people with blood cancers, and the clinicians treating people with these conditions. We’re committed to keep working with them.
What is this about?
Pharmac has looked at funding a medicine called daratumumab which can be used to treat people with a type of blood cancer called multiple myeloma. We initially assessed daratumumab in 2022. Following new information from the pharmaceutical company, we reviewed our analysis in 2025.
We put all our analysis into a report called a Technology Assessment Report (TAR). TARs are detailed records of the methods and results of Pharmac’s economic analysis.
How does Pharmac use a TAR?
Pharmac uses the results of the economic analysis to help decide whether to fund new medicines or treatments. This forms part of what we consider during our prioritisation meeting. Prioritisation also considers information about all of Pharmac’s other decision criteria (see Factors for Consideration), some of which are not part of the economic analysis.
What does economic analysis cover?
The economic analysis takes into account the clinical evidence and expert advice Pharmac has received about how well a treatment works, and how much it would cost the health sector overall.
Doing economic analysis helps Pharmac identify whether the price a pharmaceutical company is offering for a new treatment represents good value for money given how well the treatment works. When the current price offer means a treatment offers low value for money (compared to other treatments Pharmac is considering funding) we rank it lower on our options for investment list, and we may ask the supplier for a better price.
Pharmac can re-evaluate our economic analysis when we get a better price.
If the value for money or any other Factor for Consideration changes, Pharmac re-prioritises the treatment among all the other medicines we are considering funding. This allows Pharmac to make fair decisions, based on the latest information, about which treatments to fund for New Zealanders.
Expert advice about daratumumab
Pharmac received expert advice for daratumumab for multiple myeloma from our specialist Cancer Treatments Advisory Committee in November 2021 and July 2024. The advice in July 2024 was focused on whether daratumumab would be used most of the time with another treatment that Pharmac has funded for multiple myeloma (pomalidomide) and if it worked better when used with pomalidomide. You can find a record of this expert advice at:
November 2021 meeting record of the Cancer Treatment Advisory Committee [PDF, 698 KB]
July 2024 meeting record of the Cancer Treatment Advisory Committee [PDF, 2.7 MB]
Who is this for?
This medicine is being looked at for people whose multiple myeloma has come back or hasn’t responded after one round of treatment.
What does daratumumab do?
Daratumumab helps the immune system find and attack cancer cells. It can be given as an injection under the skin or through a drip into a vein.
What did the TAR say?
The original report looked at using daratumumab with two other medicines – bortezomib and dexamethasone. The second report looked at using daratumumab with two different medicines – pomalidomide and dexamethasone. Both reports incorporated advice from clinical studies and experts in treating cancer, about how well daratumumab works.
Pharmac’s expert advisors considered that either combination helped people live longer and delayed their cancer getting worse. These improvements in health are quantified as part of the economic analysis of daratumumab.
Daratumumab is very expensive
The analysis also includes the cost of daratumumab, based on the pharmaceutical company’s proposed price. The medicine is very expensive and needs to be taken for an extended period, so the cost is very high.
This means that daratumumab for multiple myeloma represents relatively low value for money compared to many other treatments Pharmac is considering funding. We use the same approach to estimate value for money across all medicines New Zealanders would like us to fund.
Our assessment looks at more than cost
While the economic analysis is an important factor that we consider, it’s not the only factor (see Factors for Consideration). Multiple myeloma is considered by Pharmac to be an area of higher health need. Research shows that the public are willing to pay more for treatments which are for people with higher need. However, Pharmac is considering many medicines for people with high health need.
The TAR provides the estimated benefits and cost to the health system in its results section compared to the treatment New Zealanders receive currently for the same health condition.
The health system costs cannot be shared publicly because they are calculated using the latest price offer from the pharmaceutical company, which is commercially sensitive.
What’s changed in the update?
This updated report reflects changes in how multiple myeloma is treated in New Zealand. Since the first report, access to lenalidomide has been widened, and a new treatment has been funded (pomalidomide). Because of this, daratumumab is now being looked at in combination with pomalidomide and dexamethasone, instead of bortezomib and dexamethasone.
The updated report shows this new combination might help people live longer and delay disease progression and the symptoms that go with it. However, there’s still no direct study looking only at how well this combination works in people who’ve had just one treatment before and these are the people who would get daratumumab in New Zealand.
This updated report describes the economic methods Pharmac used to compare daratumumab to current treatment in benefit and cost. This provides information which helps compare daratumumab to other medicines Pharmac is considering funding, based on Pharmac’s Factors for Consideration.
We cannot fund daratumumab at this time
While the current budget available to us means we are not able to fund daratumumab at this time, we will continue to work with the supplier and stay in touch with clinical experts and advocacy groups who may be able to share new published evidence about daratumumab over time. We would welcome feedback on how we have considered daratumumab for funding to ensure we have the best possible information.