Package advice on ipilimumab (Yervoy®) in combination with nivolumab (Opdivo®) for the treatment of inoperable malign pleural mesothelioma
The National Health Care Insititute has completed its assessment whether ipilimumab (Yervoy®) in combination with nivolumab (Opdivo®) can be included in the basic health care package for the treatment of patients with inoperable malign pleural mesothelioma. The National Health Care Institute advises the Minister to include ipilimumab in combination with nivolumab in the health insurance package after successful price negotiations.
Registered indication
Reimbursement is requested for the treatment of patients with inoperable malign pleural mesothelioma.
The National Health Care Institute's advice
The National Health Care Institute has concluded that ipilimumab in combination with nivolumab meets the statutory criterion of ‘established medical science and medical practice’ for the indication mentioned. Ipilimumab combination with nivolumab is an effective treatment in which a distinction must be made between the effectiveness of the different tumour-histological types: the combination mentioned has a clear added value for patients with the non-epithelioid tumour-histological type compared to chemotherapy. However, no apparent added value of the combination treatment for patients with the epithelioid tumour-histological type has been demonstrated compared to the current treatment, which means that no more than an equal value can be concluded for this group.
However, the combination of ipilimumab with nivolumab involves a significant additional cost for the health care insurance package. There are considerations for negotiating prices. We advise the Minister to include ipilimumab in combination with nivolumab in the health insurance package after successful price negotiations.