2 December 2020: OIA response: anti-vascular endothelial growth factor (“anti-VEGF”) agents

2 December 2020

Dear [name and contact details withheld] 

REQUEST FOR INFORMATION 

Thank you for your request dated 4 November under the Official Information Act 1982 (OIA) for information relating to anti-vascular endothelial growth factor (“anti-VEGF”) injections.  You wrote: 

I’m trying to find info on a Pharmac predicted increase in anti-VEGF injections. Back in 2017/2018, it’s my understanding that Pharmac predicted a 15% annual growth year on year of use of avastin in New Zealand, is this correct? Also, what is the prediction going forward, or does this prediction stand? 

We have been unable to locate any public information regarding the predicted annual growth of anti-VEGF injections however, we note that Schedule 3 of the request for proposals (“RFP”) for the supply of anti-vascular endothelial growth factor agents(external link) published on 5 May 2016 included hospital usage data for the years 2013 to 2016 (financial year (FYR) ending 30 June). For ease of reference, we have included a copy of the hospital usage data table below. 

Hospital usage

The table below indicates the approximate use of anti-VEGF agents in DHB hospitals (in mg). 

Year (FYR)

Bevacizumab (includes all indications)

Ranibizumab

 

Units Purchased (mg)

2013

72,064

230

2014

94,884

427

2015

105,956

1,629

2016*

125,747

3,257

*2016 financial year figures are best estimates from the usage data available at the time of this data being extracted. 

It should be noted that due to inconsistencies in the reporting of hospital data, the figures above may not accurately represent DHB usage. We are unable to separate the purchasing data by indication, however bevacizumab is mainly for ocular indications and some limited use in oncology. 

Additionally, in 2017, PHARMAC undertook a Budget Impact Analysis (BIA) for the use of aflibercept. This analysis used an estimated 20% growth rate of patients using bevacizumab, estimated from growth in Australian dispensing at the time (annual and compounding). 

PHARMAC has not undertaken any additional analysis to identify projections going forward. As such, we are unable to provide an estimate or projection for year on year growth of Avastin as we do not hold the information requested and do not have any reason to believe the information is either held by any other department or agency or connected more closely with the functions of another department or agency (section 18(g)). 

In order to assist with your request, we have collated the hospital usage data for bevacizumab, ranibizumab and aflibercept for FYR 2016 to 2020 and included this below. 

Hospital usage

The table below indicates the approximate use of anti-VEGF agents in DHB hospitals (in mg). 

Year (FYR)

Bevacizumab

Ranibizumab

Aflibercept

 

Units purchased (mg) (includes all indications)

2016

74,100

3,503

152

2017

93,875

4,644

104

2018

102,300

5,919

1,048

2019

89,700

1,258

30,208

2020

60,800

802

31,240

It should be noted that due to inconsistencies in the reporting of hospital data, the figures above may not accurately represent DHB usage. There are some anti-VEGF products which are extemporaneously compounded for the DHBs which are not captured in this data set. 

We are unable to separate the purchasing data by indication, however bevacizumab and ranibizumab are mainly used for ocular indications and some limited use in oncology. Aflibercept is only used for ocular indications. 

Please note you have the right, by way of complaint under section 28(3) of the OIA to an Ombudsman, to seek an investigation and review of our decision.

We trust that this information answers your queries. We are making our information more freely available, so we will now publish selected OIA responses (excluding personal details) on our website. Please get in touch with us if you have any questions about this.

Yours sincerely

Rachel Read
Manager, Policy and Government Services