Drugs, Health Technologies, Health Systems

Reimbursement Recommendation

Darolutamide (Nubeqa)

Indication: In combination with androgen deprivation therapy for the treatment of metastatic castration-sensitive prostate cancer

Sponsor: Bayer Inc.

Recommendation: Reimburse with conditions

Summary

What Is the Reimbursement Recommendation for Nubeqa?

Canada’s Drug Agency (CDA-AMC) recommends that Nubeqa be reimbursed by public drug plans for use in combination with androgen deprivation therapy (ADT) for the treatment of metastatic castration-sensitive prostate cancer (mCSPC) if certain conditions are met.

Why Did CDA-AMC Recommend Reimbursement?

A subcommittee of the pan-Canadian Oncology Drug Review Expert Review Committee (pERC) determined that Nubeqa plus ADT demonstrates acceptable clinical value versus other androgen receptor pathway inhibitors (ARPIs) plus ADT in patients with mCSPC. This determination was sufficient for the pERC subcommittee to recommend that Nubeqa plus ADT be reimbursed.

Given that Nubeqa is expected to be an alternative to other ARPI plus ADT regimens, acceptable clinical value refers to at least comparable value versus apalutamide plus ADT, enzalutamide plus ADT, and abiraterone acetate and prednisone plus ADT. Evidence from a pivotal phase III clinical trial demonstrated that darolutamide plus ADT resulted in clinically meaningful improvements compared with placebo plus ADT in outcomes that are relevant for the management of mCSPC, including time to progression to more advance disease. Although limited by imprecision, evidence from an indirect comparison suggested similar effects for darolutamide plus ADT versus the other ARPI plus ADT regimens.

Which Patients Are Eligible for Coverage?

Nubeqa should only be covered for patients who currently meet the eligibility criteria used by each of the public drug plans for the other ARPI plus ADT regimens used in the treatment of mCSPC.

What Are the Conditions for Reimbursement?

Nubeqa should only be reimbursed in accordance with the criteria used by each of the participating drug programs for other ARPI plus ADT regimens and if the drug program cost of Nubeqa does not exceed that of the least costly ARPI plus ADT regimen for the treatment of mCSPC.

Review Background

Highlights From Interested Parties’ Input

The patient groups (the Canadian Cancer Society and the Canadian Cancer Survivor Network) noted the following regarding impacts of the disease, unmet needs, and important outcomes:

The clinician groups (the Genitourinary Medical Oncology Group at the Arthur J.E. Child Comprehensive Cancer Centre, the British Columbia Cancer Genitourinary Medical Oncologists’ Group, and the Ontario Health [Cancer Care Ontario] Genitourinary Cancer Drug Advisory Committee) and the clinical experts consulted by CDA-AMC noted the following regarding unmet needs arising from the disease and place in therapy for the drug under review:

The participating public drug programs raised potential implementation issues related to considerations for initiation, generalizability of trial populations to broader populations, care provision issues, and the potential need for a provisional funding algorithm.

Recommendation

The pERC subcommittee recommends that darolutamide be reimbursed for use in combination with ADT for the treatment of mCSPC only if the conditions listed in Table 1 are met.

Table 1: Reimbursement Conditions and Reasons

Reimbursement condition

Reason

Implementation guidance

Initiation

1. Eligibility for darolutamide + ADT should be based on the criteria used by each of the public drug plans for the reimbursement of other ARPI + ADT regimens for the treatment of mCSPC.

There is insufficient evidence that darolutamide + ADT is clinically superior or inferior to the other ARPI + ADT regimens currently reimbursed for mCSPC.

Existing criteria: The reimbursement criteria for an ARPI + ADT may vary across participating drug programs, but are summarized as 1 of the following:

  • no prior ADT in the metastatic setting

  • have received ADT for no more than 6 months in the metastatic setting

  • more than 1 year has elapsed since prior ADT for early-stage disease.

Switching ARPIs: Patients who are currently receiving an alternative ARPI + ADT regimen may switch to darolutamide + ADT if there are concerns about tolerability or toxicity, provided they have not met the discontinuation criterion.

Prior ARPI: Reimbursement of darolutamide + ADT could be appropriate for those treated with an ARPI in the non-mCSPC setting, and should be authorized in accordance with the reimbursement criteria currently used for other ARPI + ADT regimens.

Discontinuation

2. Discontinuation for darolutamide + ADT should be based on the criteria used by each of the public drug plans for the reimbursement of other ARPI + ADT regimens in the treatment of mCSPC.

The existing discontinuation criteria for ARPI + ADT regimens are appropriate for darolutamide + ADT.

Existing criteria: The discontinuation criteria used by the drug programs include:

  • disease progression based on clinical, PSA, and radiographic factors

  • unacceptable toxicity.

Prescribing

3. Darolutamide + ADT should be prescribed by clinicians with expertise in managing prostate cancer.

This is meant to ensure that darolutamide is prescribed for appropriate patients and that adverse effects are managed in an optimized and timely manner.

4. Patients receiving darolutamide should also receive ADT (i.e., a gonadotropin-releasing hormone analogue concurrently or have had a bilateral orchiectomy).

This is in accordance with the indication under review.

Pricing

5. The drug program cost of darolutamide + ADT should be negotiated so that it does not exceed the drug program cost of treatment with the least costly ARPI + ADT for the same indication.

Based on the subcommittee’s assessment of the evidence, darolutamide + ADT is expected to have comparable clinical benefits and harms vs. relevant comparators. Therefore, darolutamide should be priced no more than the least costly ARPI.

Reimbursement of darolutamide + ADT may lead to an expansion in the number of patients who receive ARPI + ADT. Therefore, even if the price of darolutamide + ADT is negotiated to not exceed the drug program cost of treatment with the least costly ARPI, the expenditure on darolutamide may increase the overall budgetary amount spent by the drug plans. Additional price reductions beyond that recommended in the pricing condition may be necessary to avoid increasing the overall budget.

ADT = androgen deprivation therapy; ARPI = androgen receptor pathway inhibitor; mCSPC = metastatic castration-sensitive prostate cancer; PSA = prostate-specific antigen; vs. = versus.

Rationale for the Recommendation

The subcommittee deliberated on whether the evidence supports that darolutamide plus ADT demonstrates comparable clinical benefit and harms to 1 or more appropriate comparators in patients with mCSPC.

Based on the totality of the evidence, the subcommittee determined that darolutamide plus ADT demonstrates comparable clinical benefit and harms to other ARPI plus ADT regimens (i.e., apalutamide plus ADT, enzalutamide plus ADT, and abiraterone acetate and prednisone plus ADT) and therefore has acceptable clinical value. Evidence from a pivotal phase III clinical trial demonstrated that darolutamide plus ADT resulted in clinically meaningful improvements compared with placebo plus ADT in outcomes that are relevant for the management of mCSPC, including radiographic progression-free survival (rPFS) and time to metastatic castration-resistant prostate cancer. Although limited by imprecision, evidence from a network meta-analysis suggested similar effects for improving rPFS with darolutamide plus ADT versus the other ARPI plus ADT regimens.

Patients and clinicians identified the need for additional treatment options for patients who experience challenging or intolerable side effects with the alternative ARPI plus ADT regimens and for those who are at risk of drug-drug interactions with the alternative regimens. The subcommittee noted that darolutamide plus ADT has the potential for fewer AEs and fewer drug-drug interactions than the alternative ARPI plus ADT regimens.

Further information on the subcommittee’s discussion around clinical value is provided in the Summary of Deliberation section.

The determination of acceptable clinical value was sufficient for the subcommittee to recommend reimbursement of darolutamide. As the subcommittee recommended that darolutamide be reimbursed, it also considered whether reimbursement conditions should be added to address important economic considerations, health system impacts, or social and ethical considerations, or to ensure clinical value is realized. The resulting reimbursement conditions, with accompanying reasons and implementation guidance, are stated in Table 1.

Summary of Deliberation

The subcommittee considered all domains of value of the deliberative framework before developing its recommendation: clinical value, unmet clinical need, distinct social and ethical considerations, economic considerations, and impacts on health systems. For further information on the domains of value, please refer to Expert Committee Deliberation at Canada’s Drug Agency.

The subcommittee considered the following key discussion points, organized by the 5 domains of value.

Clinical Value

Unmet Clinical Need

Distinct Social and Ethical Considerations

Economic Considerations

Impacts on Health Systems

Sources of Information Used by the Subcommittee

To make its recommendation, the subcommittee considered the following information (links to the full documents for the review can be found on the project webpage):

pERC Information

Members of the Committee

Dr. Catherine Moltzan (Chair), Dr. Kelvin Chan (Vice Chair), Dr. Phillip Blanchette, Dr. Matthew Cheung, Dr. Michael Crump, Annette Cyr, Dr. Jennifer Fishman, Dr. Jason Hart, Terry Hawrysh, Dr. Yoo-Joung Ko, Dr. Aly-Khan Lalani, Amy Peasgood, Dr. Anca Prica, Dr. Adam Raymakers, Dr. Patricia Tang, Dr. Pierre Villneuve, and Danica Wasney

A subcommittee composed of 4 pERC members was convened. None had a conflict of interest that precluded their participation.

Meeting date: September 3, 2025