Tenofoviralafenamid (2) – Vemlidy®

Chronic hepatitis B, ≥ 12 years

Characteristics

Start date 01.10.2018 – Marketing authorisation: 09.01.2017
Resolution 22.03.2019
INN Tenofoviralafenamid
Brand name Vemlidy®
Pharm. company Gilead Sciences GmbH
G-BA Procedure ID D-394
ATC code J05AF13 Nucleoside and nucleotide reverse transcriptase inhibitors (J05AF)
ICD-10 codes (AIS) B18.0Chronic viral hepatitis B with delta-agent, B18.11, B18.12, B18.13, B18.19
Alpha-ID codes (AIS) I100035Chronic viral hepatitis B, I126275Chronic viral hepatitis B without delta virus, phase 1, I126279Chronic viral hepatitis B without delta virus, phase 2, I126287Chronic viral hepatitis B without delta virus, phase 3, I29600Chronic viral hepatitis B with delta virus
DDD 25 mg O
Therapeutic area Infectious diseases Hepatitis B / Hepatitis D (HBV / HDV)
Reason for procedure Reassessment: G-BA limitation
Original resolution: Tenofoviralafenamid (1) (21.09.2017)

Therapeutic indication of the resolution

Vemlidy is indicated for the treatment of chronic hepatitis B in adults and adolescents (aged 12 years and older with body weight at least 35 kg).

Subpopulation Indication Comparator
a) Treatment-naïve adult patients with chronic hepatitis B (Peg-)interferon alfa or tenofovirdisoproxil or entecavir
b) Therapy-experienced adult patients with chronic hepatitis B Patient-specific therapy, with choice of (peg-)interferon alfa, tenofovirdisoproxil, entecavir, adefovirdipivoxil, lamivudine and telbivudine.
c) Therapy-naïve adolescent patients aged 12 years and older with chronic hepatitis B Tenofovirdisoproxil or entecavir
d) Therapy-experienced adolescent patients aged 12 years and older with chronic hepatitis B Tenofovirdisoproxil

Studies and Results

No. of studies
(best subpopulation)
4 (GS 108, GS 108-C, GS 110, GS 110-C)
Study design
(best subpopulation)
H2H vs. ACT
Meta analysis
(best subpopulation)
yes
Reason for dividing into subpopulations (G-BA) Previous treatment, Age

  • Clinical trials
    • To demonstrate the additional benefit, the pharmaceutical manufacturer has submitted interim results from the randomised, double-blind and multicentre clinical trials GS108, GS108-C, GS110 and GS110-C.
    • These studies are regulatory trials comparing tenofovir alafenamide with tenofovir disoproxil in treatment-naïve and treatment-experienced adult patients with chronic hepatitis B infection who tested positive (GS110/-C) or negative (GS108/-C) HBe antigen status, respectively.

b) treatment-experienced adult patients with chronic hepatitis B

  • For treatment-experienced adult patients with chronic hepatitis B, the additional benefit of tenofovir alafenamide over the appropriate comparator therapy is not proven.
  • No relevant data are available for assessing the additional benefit of tenofovir alafenamide compared with the appropriate comparator therapy.
  • Although treatment-experienced patients were also included in studies GS108, GS108-C, GS110 and GS110-C, the appropriate comparator therapy tailored to the individual patient was not implemented for these patients.
  • It is therefore not possible to infer any additional benefit from the available data.

c) Treatment-naive adolescent patients aged 12 years and over with chronic hepatitis B

  • For treatment-naive and treatment-experienced adolescent patients aged 12 years and over with chronic hepatitis B, the additional benefit of tenofovir alafenamide compared with the appropriate comparator therapy is not proven.
  • No results from clinical trials were submitted for the benefit assessment for patient populations c) and d).
  • The pharmaceutical manufacturer’s search failed to identify any relevant studies, meaning that no comparison with the appropriate comparator therapy is possible.
  • No conclusions regarding additional benefit can be drawn.

d) treatment-experienced adolescent patients aged 12 years and over with chronic hepatitis B

  • For treatment-naïve and treatment-experienced adolescent patients aged 12 years and over with chronic hepatitis B, the additional benefit of tenofovir alafenamide compared with the appropriate comparator therapy is not proven.
  • No results from clinical trials were submitted for the benefit assessment for patient populations c) and d).
  • The pharmaceutical manufacturer’s search failed to identify any relevant studies, meaning that no comparison with the appropriate comparator therapy is possible.
  • No conclusions regarding additional benefit can be drawn.

Courtesy translation only, please refer to the German original.

Associated procedures

Tenofoviralafenamid (2) Vemlidy® Gilead Sciences GmbH Infectious diseases Chronic hepatitis B, ≥ 12 years 12,400–38,100 100% additional benefit not proven
Tenofoviralafenamid (1) Vemlidy® Gilead Sciences GmbH Infectious diseases Chronic hepatitis B, ≥ 12 years 0
12,400–38,100
100% additional benefit not proven repealed


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