ACE Technology Guidances

ACE Technology Guidances communicate recommendations from the MOH Drug Advisory Committee or the MOH Medical Technology Advisory Committee on the funding status and appropriate use of drugs, vaccines or medical technologies that have been evaluated by ACE. The guidances also include the Committee’s rationale for the funding recommendations, and key clinical and economic evidence which informed their deliberations. Plain English Summaries (PES) to explain ACE Technology Guidances are available for patients and the public.

Published on 12 Jul 2022
Last Updated on 02 Jan 2024

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Guidance Recommendations
The Ministry of Health's Drug Advisory Committee has recommended: Avelumab 200 mg/10 mL concentrate for solution for infusion; and Pembrolizumab 100 mg/4 mL solution for infusion for treating advanced urothelial carcinoma (UC) in line with specific clinical criteria.
Subsidy status
Avelumab 200 mg/10 mL concentrate for solution for infusion is recommended for inclusion on the Medication Assistance Fund (MAF) for maintenance treatment of locally advanced or metastatic UC that has not progressed with first-line platinum-based chemotherapy when used in line with the treatment regimen outlined in the Annex. Pembrolizumab 100 mg/4 mL solution for infusion is recommended for inclusion on the MAF for treating patients with locally advanced or metastatic UC after receiving platinum-based chemotherapy in line with the following criteria: Patients must not have received prior treatment with a PD-1/PD-L1 inhibitor for locally advanced or metastatic UC; and Treatment with pembrolizumab should be stopped at 2 years, or earlier if disease progresses. Pembrolizumab retreatment is allowed at time of progression for up to 1 additional year if the initial treatment was stopped for reasons other than disease progression. MAF assistance for the abovementioned treatments will be implemented from 1 September 2022. MAF assistance does not apply to pembrolizumab when used for patients with untreated PD-L1-positive UC who are unable to receive cisplatin-based chemotherapy, or erdafitinib when used for treating UC with FGFR3 genetic alterations. *Clinical indications, subsidy class and MediShield Life claim limits for all drugs included in the evaluation are provided in the Annex.*

Guidance Recommendations

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

Avelumab 200 mg/10 mL concentrate for solution for infusion; and
Pembrolizumab 100 mg/4 mL solution for infusion

for treating advanced urothelial carcinoma (UC) in line with specific clinical criteria.

Subsidy status

Avelumab 200 mg/10 mL concentrate for solution for infusion is recommended for inclusion on the Medication Assistance Fund (MAF) for maintenance treatment of locally advanced or metastatic UC that has not progressed with first-line platinum-based chemotherapy when used in line with the treatment regimen outlined in the Annex.

Pembrolizumab 100 mg/4 mL solution for infusion is recommended for inclusion on the MAF for treating patients with locally advanced or metastatic UC after receiving platinum-based chemotherapy in line with the following criteria:

Patients must not have received prior treatment with a PD-1/PD-L1 inhibitor for locally advanced or metastatic UC; and
Treatment with pembrolizumab should be stopped at 2 years, or earlier if disease progresses. Pembrolizumab retreatment is allowed at time of progression for up to 1 additional year if the initial treatment was stopped for reasons other than disease
progression.

MAF assistance for the abovementioned treatments will be implemented from 1 September 2022.

MAF assistance does not apply to pembrolizumab when used for patients with untreated PD-L1-positive UC who are unable to receive cisplatin-based chemotherapy, or erdafitinib when used for treating UC with FGFR3 genetic alterations.

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

Review of cancer drugs for treating advanced urothelial carcinoma (Updated 2 Jan 2024) PES Treatments for advanced urothelial cancer (Updated 2 Jan 2024)