Ramucirumab [Cyramza]

[MSHL] Ramucirumab Concentrate For Solution For Infusion 100 mg/10 mL, 500 mg/50 mL

1. Treatment of advanced unresectable hepatocellular carcinoma in patients with disease progression after 1 or more prior lines of systemic therapy, and who have serum alpha-fetoprotein (AFP) of ≥400 ng/ml, and have adequate liver function as assessed by the Child-Pugh scoring system.

2. Ramucirumab as monotherapy for patients with unresectable locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma, with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy.

3. Ramucirumab in combination with paclitaxel for patients with unresectable locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma, with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy.

4. Ramucirumab in combination with FOLFIRI for treating metastatic colorectal cancer that has progressed on first-line systemic therapy.

Legend

This section shows the following:

• Subsidy Scheme and Clinical Indication (where applicable) of drugs listed in the MOH List of Subsidised Drugs

• Subsidised brands of vaccines recommended in the National Immunisation Schedules listed in the MOH Subsidised Vaccine List

• Cancer Drug and Clinical Indication listed in the MediShield Life Cancer Drug List

As this website is updated monthly, please refer to MOH List of Subsidised Drugs, MOH Subsidised Vaccine List or MediShield Life Cancer Drug List for the most updated information.

02/01/2024 Review of cancer drugs for previously treated advanced hepatocellular carcinoma

The Ministry of Health’s Drug Advisory Committee has recommended:

• Cabozantinib 20 mg, 40 mg and 60 mg tablets; and

• Regorafenib 40 mg tablet

for treating advanced unresectable hepatocellular carcinoma in patients with disease progression after one or more prior lines of systemic therapy, and who have adequate liver function as assessed by the Child-Pugh scoring system.

Funding status

[R] Regorafenib 40 mg tablet is recommended for inclusion on the Medication Assistance Fund (MAF) for the abovementioned indication with effect from 4 January 2022.

[R] Cabozantinib 20 mg, 40 mg and 60 mg tablets are recommended for inclusion on the MAF for the abovementioned indication with effect from 1 September 2022.

[NR] MAF assistance does not apply to any formulations or strengths of ramucirumab, pembrolizumab, nivolumab and ipilimumab when used for previously treated advanced hepatocellular carcinoma.

Clinical indications, subsidy class and MediShield Life claim limits for all drugs included in the evaluation are provided in the Annex.

19/12/2022 Review of cancer drugs for previously treated advanced gastric cancer

The Ministry of Health’s Drug Advisory Committee has recommended:

• Nivolumab 40 mg/4 mL and 100 mg/10 mL concentrate for solution for infusion for treating patients with unresectable locally advanced or recurrent gastric or gastroesophageal junction (GEJ) adenocarcinoma after two or more prior systemic therapies in line with the following criteria:

  • Patients must not have received prior treatment with a PD-1/PD-L1 inhibitor for unresectable locally advanced or recurrent gastric or GEJ cancer; and

  • Nivolumab should be given as a weight-based dose up to a maximum of 240 mg every two weeks or 480 mg every four weeks.

Subsidy status

[R] Nivolumab 40 mg/4 mL and 100 mg/10 mL concentrate for solution for infusion are recommended for inclusion on the Medication Assistance Fund (MAF) for the abovementioned indication with effect from 1 September 2022.

[NR] MAF assistance does not apply to any formulations or strengths of pembrolizumab, ramucirumab, regorafenib or trifluridine/tipiracil when used for previously treated advanced gastric cancer.

Clinical indications, subsidy class and MediShield Life claim limits for all drugs included in the evaluation are provided in the Annex.

12/07/2022 Aflibercept, bevacizumab and ramucirumab for treating metastatic colorectal cancer

[NR] The Ministry of Health’s Drug Advisory Committee has not recommended aflibercept, bevacizumab reference biologic (Avastin) or ramucirumab for subsidy for treating metastatic colorectal cancer.

[NR] Bevacizumab (Avastin) has not been recommended in view of unfavourable cost effectiveness compared with bevacizumab biosimilar (Mvasi) at the price proposed by the manufacturer.

[NR] Aflibercept has not been recommended due to low clinical need and unfavourable cost effectiveness compared with Mvasi.

[NR] Ramucirumab has not been recommended following a request from the manufacturer to not consider it for subsidy.

Clinical indications, subsidy class and MediShield Life claim limits for all drugs included in the evaluation are provided in the Annex.

Legend

This section displays recommendation from the MOH Drug Advisory Committee for subsidy and appropriate use of the drug as extracted from the Agency for Care Effectiveness (ACE) Drug Guidances. As this website is updated monthly, please refer to the ACE website for the most updated information.

Note:

General availability information reflected is based on the Public Healthcare Institutions’ (PHI) formulary on what is commonly used for treating their patient population and may or may not be available for patients not under the care of that institution. It does not reflect the PHI’s actual inventory availability and is subjected to change. Please consult the Public Hospitals or Polyclinics for details on availability and supply restrictions/considerations. General availability is not tied to any brand unless otherwise stated.

Users are to consult the respective PHIs for actual inventory availability and supply restrictions/consideration