MSAC recommends expansion of BRCA testing in advanced breast cancer

The Medicare Services Advisory Committee (MSAC) has recommended an expansion of funding for BRCA genetic testing, recommending its inclusion for patients with advanced breast cancer to assess their eligibility for PARP inhibitor treatments.

The recommendation was made in response to AstraZeneca’s application seeking to amend the existing MBS item 73295, which facilitates the detection of germline BRCA1 and BRCA2 pathogenic variants. The aim is to enable access to Lynparza (olaparib) under the Pharmaceutical Benefits Scheme (PBS).

Currently, BRCA testing is supported under the MBS for patients with ovarian cancer and specific subtypes of early breast cancer, such as triple-negative or hormone receptor-positive, HER2-negative breast cancers with high-risk characteristics. However, the application advocated for extending MBS funding to include patients with HER2-negative metastatic breast cancer who have undergone prior (neo)adjuvant chemotherapy. This would align with a PBS funding application for Lynparza in the same patient cohort, which received approval from the Pharmaceutical Benefits Advisory Committee (PBAC) in July 2024.

MSAC’s recommendation received strong backing from the Medical Oncology Group of Australia (MOGA), which emphasised the importance of funding for patients with both locally advanced and metastatic breast cancer. “

MSAC noted the great need for patients with advanced disease to access testing as soon as possible so that a relevant treatment (e.g., olaparib) can be started without unnecessary delay. MSAC therefore supported the expansion of the testing population to include all patients with breast cancer, rather than limiting testing to patients with certain subtypes of breast cancer,” the Committee stated.

Furthermore, MSAC highlighted the broader implications of BRCA testing, including its utility in identifying patients at high risk of developing cancers, guiding preventative measures, and informing eligibility for treatments like carboplatin chemotherapy. The Committee also acknowledged the potential for preventing breast and ovarian cancers through surgical interventions and prophylactic medications.

The recommendation includes an important consideration for family members of patients found to carry BRCA1 or BRCA2 pathogenic or likely pathogenic variants. MSAC advised that these individuals should also consider BRCA testing, given the increased cancer risk associated with these genetic variants.

To streamline future access to treatments, MSAC suggested revising the MBS item description to specify eligibility for “a relevant treatment under the PBS” rather than naming specific drugs or drug classes. This approach aims to “future-proof” the criteria, enabling rapid access to emerging therapies without bureaucratic delays.

In reimagining healthcare across the entire patient journey, Health Industry Hub^TM is the only one-stop-hub uniting the diversity of the Pharma, MedTech, Diagnostics & Biotech sectors to inspire meaningful change.

The Health Industry Hub^TM content is copyright protected. Access is available under individual user licenses. Please click here to subscribe and visit T&Cs here.