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Table 5 Clinical and patient-reported outcomes data considered by the German Federal Joint Committee for rare diseases

From: Patient-reported data informing early benefit assessment of rare diseases in Germany: A systematic review

   Clinical dataPatient-reported outcome data 
SubstanceGroup of diseaseMortalityMorbidityClinical PROsHRQoLPreferencesSatisfactionBenefit score
1Tisagenlecleucel (1st application area)Oncologic diseasesOverall survival (OS)Progression free survival (PFS), overall response rate (ORR)n/aFACT-Lym, SF-36, no usable datan/an/anon-quantifiable
2Tisagenlecleucel (2nd application area)Oncologic diseasesOSComplete response/remission (CR), relapse free survival (RFS), MRD-negativ-statusEQ-5D VAS, no usable dataPedsQL (no useable data)n/an/anon-quantifiable
3Gemtuzumab OzogamicinOncologic diseasesOSRFS, event-free survival (EFS), CR, rate of stem cell transplantsn/an/an/an/anon-quantifiable
4Velmanase alfaMetabolic diseasesdeaths, no eventsSerum-Oligosaccharid-concentration, Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), audiological performance with pure tone audiometry (dBHL), 3-min-stair-climbing-test, FVC, FEV, 6-min-walk-testChildhood Health Assessment Questionnaire (CHAQ), EQ-5D-5 L Indexn/an/an/anon-quantifiable
5DarvadstrocelDigestive disordersn/aCombined remission, clinical remission, Perianal Disease Activity Index (PDAI) (partially), no reoccurrence after clinical remission, time to clinical remission, Perianal Disease Activity Index (PDAI),Perianal Disease Activity Index (PDAI) (partially)Inflammatory Bowel Disease Questionnaire (IBDQ)n/an/anon-quantifiable
6BurosumabMetabolic diseasesNoneRachitis symptoms with Rickets Severity Scale (RSS), serumphosphat, anthropometric parameters, physical resilience (6MWT), motoric abilities (Bot-2-scale), function and pain (POSNA-PODCI), Rachitis symptoms (Radiographic Global Impression of Change (RGI-C)), pain intensity (Faces Pain Scale-Revised (FPS-R))PROMIS (function, pain, fatigue)SF-10 (no usable data)n/an/anon-quantifiable
7GlycerolphenylbutyratMetabolic diseasesNone24-h-AUC-ammoniac-concentration in the bloodn/aSF-36, SF-15, no usable datan/an/anon-quantifiable
8LetermovirMetabolic diseasesOSClinical relevant CMV-infection, CMV-organ disease, induction of a preemptive therapy, rehospitalization (general and after CMV-reactivation), Graft-versus-Host Disease, opportunistic bacterial, viral, and fungus infectionsn/an/an/an/anon-quantifiable
9Allogenic, genetic modified T-cellsOncologic diseasesOS, median survival, 1-year survival, 10-year survivalImmune reconstruction, acute and chronic GvHD (occurrence, time to progression)n/an/an/an/anon-quantifiable
10Brentuximab Vedotin (new application area)Oncologic diseasesOSPFS, ORR, hospitalization, cutane symptomatic – symptomatic domain skindex, skin changes, mSWAT-Total-Scores, complete remission (mSWAT)EQ-5D VASFACT-G (quality of life), Skindex-29 (quality of life)n/an/aminor
11NiraparibOncologic diseasesOSPFSFOSI, no usable datano usable datan/an/anon-quantifiable
12CenegerminDiseases of the eyemortalitiesRecovery of the corneal epithelium (FDA-definition), improvement of the best corrected visual acuity, progression of the lesion depth up to cornea melting, or perforation, cornea infectionEQ-5D VASNEI VFQ-25-scoren/an/anon-quantifiable
13TelotristatethylOncologic diseasesn/aStool frequency, abdominal pain, compulsory stool, nausea, adequate improvement of the gastrointestinal symptoms of the carzinoid-syndromEORTC QLQ-C30 – diarrhea, sleeplessnessdisease related worrying (EORTC QLQ-GI.NET21)n/an/anon-quantifiable
14MidostaurinOncologic diseasesOS, 5-year survivalDisease free survival, CR, rate of stem cell transplantsn/aA: n/a / B: SF-12n/an/aconsiderable
15Obinutuzumab (new application area)Oncologic diseasesOSPFSn/aFACT-Lym subscale, FACT-Gn/an/anon-quantifiable
16AvelumabOncologic diseasesOSPFSEQ-5D-VAS (health state), no usable dataFACT-M, no usable datan/an/anon-quantifiable
17Elosulfase alfa (new benefit assessment)Metabolic diseasesn/aChange of walk distance, change of 3MSCT, anthropometry, respiratory functioning, wheelchair use, usage of walk aids, anthropometry, respiratory functioningMPS Health Assessment Questionnaire (MPS HAQ)n/an/an/aminor
18Daratumumab (new benefit assessment, > 50 mio € limit, new application area multiple myeloma after one pretherapy)Oncologic diseasesOSPFSA: EQ-5D VAS (health state), EORTC QLQ-C30 (symptom scales), B: no relevant dataA: EORTC QLQ-C30 (health state, function scales) B: no relevant datan/an/aconsiderable
19Carfilzomib (new benefit assessment, > 50 mio. € limit)Metabolic diseasesOSPFSEORTC QLQ-C30 (symptom scales), EORTC QLQ-MY20 (time till first deterioration)EORTC QLQ-C30 (function scale), EORTC QLQ-MY20 (time till deterioration)n/an/anon-quantifiable
20Inotuzumab OzogamicinOncologic diseasesOSCR, MRD-negativity rate within patients with CR/Cri, HSZT rateEORTC QLQ-C30 (symptom scale) (time till deterioration), no usable data, EQ-5D-VAS (health state) (time till deterioration)EORTC QLQ-C30 (quality of life, time till deterioration), no usable datan/an/aminor
21NusinersenDiseases of the nervous systemOS, 5 year survivalDisease free survival, rate of complete remission, rate of stem cell transplantsn/aNo data consideredn/an/aconsiderable
22Cerliponase alfaMetabolic diseasesn/aProportion of responder (ML-scale), decrease of the ML−/HML-scale, time to stable decrease of ≥2 points or occurrence of value 0 on ML−/HML-scale, point value change on the ML−/HML-scale, response rate ML-scale, ML-scale, MLV-scale, MLVS-scalen/aPedsQL (Parent report for toddlers)n/an/anon-quantifiable
23Blinatumomab (re-evaluation after expiry of the term)Oncologic diseasesOSCR/CRh/CRi rate, MRD-remission rate, rate of patients with post-baseline allo-HSZTEORTC QLQ-C30 (symptom scale, time to decrease), no usable data, ALLSS (time till decrease), no usable dataEORTC QLQ-C30 (function scale, time till deterioration), no usable datan/an/aconsiderable
24IxazomibOncologic diseasesOSPFSBPI-SF, EQ-5D-VASEORTC QLQ-C30, EORTC QLQ-MY20n/an/anon-quantifiable
25ObeticholsäureDigestive disordersdeaths, one eventProportion of patients with ALP < 1,67 x ULN, ALP < 1,67, Bilirubin = <ULN, ALP reduction = > 15%Pruritus (5D und VAS)PBC-40 (quality of life)n/an/anon-quantifiable
26VenetoclaxOncologic diseasesOSPFSEQ-5D VAS, MDASIEORTC QLQ-C30n/an/anon-quantifiable
27OlaratumabOncologic diseasesOSPFSn/an/an/an/aconsiderable
28Macitentan (new benefit assessment, > 50 mio € limit)Cardiovascular diseasesn/an/an/an/an/an/anot proven
29Ibrutinib (new application area))Oncologic diseasesOSPFSEORTC QLQ-C30 (symptom scales, time to improvement/deterioration), FACIT Fatigue (time to improvement/deterioration), EQ-5D-5 L VAS (health state, time to improvement/deterioration)EORTC QLQ-C30 (function scales, time to improvement/deterioration)n/an/aconsiderable
30Teduglutid (new application area)Digestive disordersn/apE volume reduction/change, total withdrawal of pE, pE reductionn/an/an/an/anon-quantifiable
31TasimelteonDiseases of the nervous systemn/aCGI-C (health state)UQ-dTSD (Upper Quartile Daily Total Sleep Duration), dTSD (Daily Total Sleep Time)n/an/an/anon-quantifiable
32PitolisantDiseases of the nervous systemn/aEpworth Sleepiness Scale (ESS), response analysis ESS, daily kataplexie-ratefrequency and severity of narcolepsy-symptoms (sleep diary), EQ-5D VASn/an/an/anon-quantifiable
33Brentuximab Vedotin (new application area)Oncologic diseasesOSPFS, time to first occurrence of B-symptoms (TTBS), time till onset of an allogene transplantation (TTAllo)EQ-5D VASNo data availablen/an/anon-quantifiable
34Carfilzomib (new application area) [annulled]Oncologic diseasesOSPFSEORTC QLQ-C30 (symptom scales)EORTC QLQ-C30 (function scales), EORTC QLQ-MY20, FACT/GOG-Ntxn/an/aminor
35Ibrutinib (new application area)Oncologic diseasesn/an/an/an/an/an/anot proven
36Obinutuzumab (new application area)Oncologic diseasesOSPFSEQ-5D VASFACT-LymS, FACT-Gn/an/anon-quantifiable
37Eftrenonacog alfaDiseases of the blood and blood-forming organsn/aAnnualized bleeding rateEQ-5D-Y (VAS)Haem-A-QoL, CHO-KLATn/an/anon-quantifiable
38Daratumumab [annulled]Oncologic diseasesnumber of deceased, median overall survival in monthsPFSn/aNo usable datan/an/anon-quantifiable
39Albutrepenonacog alfaDiseases of the blood and blood-forming organsn/aAnnualized bleeding raten/aHaemo-QoLn/an/anon-quantifiable
40MigalastatMetabolic diseasesn/aCardiac endpoints, cerebrovascular endpoints, mGFRiohexol, and eGFRCKD-EPIBPI-SF (pain scale)SF-36v2n/an/anon-quantifiable
41Ataluren (reevaluation after date of expiration)Musculoskeletal diseasesn/aWalk distance 6MWT, time till persisting deterioration (10%), changes in TFT, walk distances, NSAA score, time for four stairs (up and down)n/aPedsQL, PODCI (Pediatric Outcomes Data Collection Instrument)n/an/aminor
42AfamelanotidMetabolic diseasesn/aSunshine expositionPain scale during phototoxic episodes, photoic episodes (self-reported, patient diary)DLQI changes (overall score)n/an/anon-quantifiable
43Ibrutinib (new benefit assessment, > 50 mio € limit)Oncologic diseasesOSPFSEQ-5D VASFACT-G, FACT-LymSn/an/anon-quantifiable
44Blinatumomab [annulled]Oncologic diseasesOSCR/CRh, MRD-response, alloHSZT eligible patients with transplantationn/an/an/an/anon-quantifiable
45Carfilzomib [annuled]Oncologic diseasesOSPFSn/aEORTC QLQ-C30 (health state/quality of life), EORTC QLQ-MY20 (disease symptoms)n/an/anon-quantifiable
46Ivacaftor (new application area)Metabolic diseasesn/aBMI change, BMI z-score change, pulmonary exacerbation, lung functioning, response analysis lung functioningn/aCFQ-Rn/an/aminor
47IsavuconazolInfectious diseasesOSClinical response according to the data review committeen/an/an/an/anon-quantifiable
48Asfotase alfaMetabolic diseasesOSSurvival without invasive ventilation, anthropometric data, motoric functioning,Pain/disability (POSNA PODCI), Pain (BPI-SF), Lower Extremity Functional Scale (LEFS)n/an/an/anon-quantifiable
49IdebenonDiseases of the eyen/aChanges in visual acuity, protan- and tritan-color-perceptionn/aNo usable datan/an/anon-quantifiable
50PanobinostatOncologic diseasesOSPFSn/aEORTC-OQL-C30, QLQ-MY-20, FACT/GOG-NTX, no valid resultsn/an/anon-quantifiable
51Pomalidomid (new benefit assessment, > 50 mio € limit)Oncologic diseasesOSPFSEORTC QLQ-C30 (time till deterioration of symptoms), EORTC QLQ-MY20 (time till deterioration of symptoms)EORTC QLQ-C30EORTC QLQ-C30 (time till deterioration), EORTC QLQ-MY20 (time till deterioration)n/an/aconsiderable
52Sebelipase alfaMetabolic diseasesnumber of survivalsAge related weight, normalization of ALT-values, LDL-C concentrationFACIT-FatigueChronic Liver Disease Questionnaires (CLDQ), PedsQLn/an/anon-quantifiable
53LenvatinibOncologic diseasesOSPFSn/an/an/an/anon-quantifiable
54Olaparib [annulled]Oncologic diseasesOSPFSn/aFunctional Assessment of Cancer Therapy-Ovarian (FACT-O)n/an/anon-quantifiable
55EliglustatMetabolic diseasesn/aChange of spleen volume in percent, morbidityBrief Pain Inventory (BPI), Fatigue Severity Scale (FSS)Fatigue (Fatigue Severity Scale, FSS)SF-36n/an/anon-quantifiable
56Nintedanib (new application area)Respiratory diseasestime till death, time till respiratory induced deathTime till first acute exacerbation, time till first adjusted acute exacerbation, annual decrease of FVCn/aSGRQ-(≤ −4 point)-Responder, SGRQ-changes, SGRQ-I-score (no usable data), SOBQ-score (no significant data), CASA-Q-score cough-score (no significant data)n/an/aminor
57Ramucirumab [annulled]Oncologic diseasesOSPFSEORTC QLQ-C30 (symptoms, responder analysis symptoms), EQ-5D VAS (health state)EORTC QLQ-C30 (health related quality of life, responder analysis)n/an/aminor
58Pasireotid (new application area)Metabolic diseasesn/aBiochemical controls (GH + IGF-1, GH, reduction of tumor volume (25%), improvements of symptomsn/aAcroQoL, no significant datan/an/aminor
59Ataluren [annulled]Musculoskeletal diseasesn/aWalk distance (6MWT, MW (m)), standing up from the back position, 10 m walk, climbing 4 stairs, descending 4 stairsn/aPediatric Quality of Life Inventory (PedsQL)n/an/aminor
60Ibrutinib [annulled]Oncologic diseasesOSOverall response rate (IRC-assessment), PFSn/aNo usable datan/an/anon-quantifiable
61AlipogentiparvovecMetabolic diseasesn/an/an/an/an/an/anon-quantifiable
62TeduglutidDigestive disordersn/aResponse, withdrawal of pE, shortening of pEn/aSBS-QoLn/an/aminor
63Ivacaftor (new application area)Metabolic diseasesn/aChange of FEV, change of BMI after 8 weeks, pulmonale eyazerbationn/aCFQ-R (respiratory system)n/an/aminor
64ObinutuzumabOncologic diseasesOSIRC-indicated PFSn/aEORTC QLQ-C30 (no significant results)n/an/anon-quantifiable
65CabozantinibOncologic diseasesOSn/aMDASI-THY (symptom scale)MDASI-THY (quality of life)n/an/aminor
66SiltuximabOncologic diseasesOSTumor response (CR and PR), fading symptoms, cancellation of corticosteroid-treatment, failure of treatmentMCD-SS (symptoms), FACIT-F-(questionnaire) (Fatigue)SF-36, Physical Component Score (PCS), Mental Component Score (MCS)n/an/anon-quantifiable
67Elosulfase alfa [annulled]Metabolic diseasesn/aWalk distance changes, changes in 3MSCTMPS Health Assessment Questionnaire (MPS HAQ)n/an/an/aminor
68CholsäureMetabolic diseasesn/an/an/an/an/an/anon-quantifiable
69Ruxolitinib (new benefit assessment, > 50 mio € limit)Oncologic diseasesOSMilt volume reduction, MFSAF v2.0MFSAF v2.1, EORTC QLQ-C30 (no usable data)EORTC QLQ-C30 (quality of life)n/an/aconsiderable
70RiociguatCardiovascular diseasesOSChanges in six-minutes-walk-distance (6MWD), changes in WHO−/NYHA-functioning classes, clinical deterioration, changes in dyspnea and fatigue (borg-scale)n/aEQ-5d-Index, LPH-questionnairen/an/aminor
71Macitentan [aufgehoben]Cardiovascular diseasesDeath till EOSReaching first morbidity or mortality event (EOT), changes in the 6-min-walk-distance, hospitalization, changes in the Borg-dyspnea-index, improvement of the WHO/NYHA-classn/aSF-36n/an/aminor
72Pomalidomid [annulled]Oncologic diseasesOSPFSn/aEORTC QLQ-C30 (No significant results in 13 of 15 subscales, physical functioning and nausea improvement), EORTC QLQ-MY20, EQ-5D (no significant results)n/an/aconsiderable
73PonatinibOncologic diseasesdeath cases, OSHematologic response (HR), zytogenic response (CCyR), PFS, molecular responsen/an/an/an/anon-quantifiable
74BosutinibOncologic diseasesOSZytogenic response (CyR), molecular response, hematologic response, PFSn/aEQ-5D (no usable data), Fact-Leu (no usable data)n/an/anon-quantifiable
75Brentuximab VedotinOncologic diseasesOSPFS, event-free survival, objective response rate, complete remission, decline B-symptoms, stem cell transplant raten/an/an/an/anon-quantifiable
76DecitabinOncologic diseasesOSCRn/aEORTC QLQ-C30 (no valid data), EORTC QLQ-C30 (no valid data)n/an/aminor
77Ruxolitinib [annulled]Oncologic diseasesOSSpleen volume reduction (MFSAF) version 2.0EORTC QLQ-C30 (fatigue)EORTC QLQ-C30 (quality of life), EORTC QLQ-C30, FACT-Lym (no valid data)n/an/aminor
78IvacaftorMetabolic diseasesn/aFEV (1%), BMI (inkl. Z-Wert), pulmonary exacerbation (PE)CFQ-R (respiratory system, child and parents), EQ-5Dn/an/an/aconsiderable
79PasireotidMetabolic diseasesn/aProportion of responders, proportion of reducers, mUFC-basic value, blood pressure, LDL-cholesterol, weightBeck-Depressions-InventarCushing’s Quality of Life Questionnaires Questionnaire (CushingQoL)n/an/aminor
80Tafamidis MegluminOther diseasesn/aNeuropathy Impairment scale of the lower limb (NIS-LL), NIS-LL respondern/aNorfolk QOL-DNn/an/aminor
81PirfenidonRespiratory diseasesn/an/an/an/an/an/anon-quantifiable
  1. Data source: German Federal Joint Committee (GBA), GBA decisions, table of study results according to the presented endpoints