Fulvestrant: where the agencies disagree
This page collects every recorded health technology assessment decision for one molecule across the agencies in our archive, and compares them. The comparison is the point: each agency publishes its own verdict, none publishes how that verdict sits against the others.
What the record shows
PBAC (Australia) and TLV (Sweden) recommended or restricted fulvestrant, while NICE (England) did not recommend it.
On the same population the two systems disagree outright: PBAC (Australia) recorded recommended for “Breast cancer”, while SMC (Scotland) recorded not recommended for “Metastatic breast cancer”.
HAS (France) has been harder on fulvestrant than on its own caseload: it refused 2 of 5 decisive submissions here (40%), against a base rate of 11% across everything it has assessed.
The file has been open for more than a decade: 17.9 years separate the first record, 8 Aug 2004 at SMC (Scotland), from the most recent, 2022 at PBAC (Australia).
SMC (Scotland) changed its position: not recommended on 8 Aug 2004, recommended by 7 Feb 2016, after a resubmission.
No assessment is on file from CIPM (Spain) and G-BA (Germany), each among the eight highest-volume agencies here.
Not every gap is a refusal: for fulvestrant, 1 submission was never made — an outcome set by the company rather than the assessor.
Against its own class, fulvestrant is an outlier: 57% of its decisive outcomes were positive, where molecules sharing ATC class L02B average 78%.
7 distinct indication wordings are recorded for fulvestrant by the agencies that label one in English (AWMSG, NICE, PBAC and SMC).
2 of these 19 records carry a year of decision but no day, so any interval quoted here is approximate to within a year.
SMC (Scotland) was first to assess fulvestrant, on 8 Aug 2004; PBAC (Australia) did not open a file until 2020 — an unusually long tail of 15.9 years between the earliest and latest system to look at it.
The record arrives in waves: 5 separate years each carry two or more decisions, spread across 9 years in total.
7 of the 7 agencies here assessed fulvestrant more than once, HAS (France) most often at 5 entries — repeat review is the norm for this molecule rather than the exception.
7 of the 18 agencies in this archive hold a record for fulvestrant.
The full ledger for fulvestrant reads 7 recommended, 6 not recommended, 2 deferred to NICE and 1 other, with 3 in other categories.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| PBAC (Australia) | 2022 | Breast cancer | The PBAC advised that the July 2020 recommendation could be revoked, noting that other bra… | source |
| HAS (France) | 9 Sep 2020 | Listing (Transparency Committee) | SMR substantial · ASMR V | source |
| PHARMAC (New Zealand) | 21 Feb 2019 | Breast cancer - locally advanced or metastatic breast cancer (1st line treatment) | PTAC advice: Decline · decision reached | source |
| AWMSG (Wales) | 13 Nov 2018 | In combination with palbociclib for the treatment of hormone receptor-positive, human epidermal growth factor receptor 2… | excluded, NICE appraised | source |
| NICE (England) | 31 Jan 2018 | NICE TA503 | not recommended | source |
14 further decisions for fulvestrant, across 7 agencies, are not shown here. They link to 12 further source documents.
Related molecules
- enzalutamide — same ATC class L02B — Endocrine therapy
- darolutamide — same ATC class L02B — Endocrine therapy
- apalutamide — same ATC class L02B — Endocrine therapy
- abiraterone — same ATC class L02B — Endocrine therapy
- relugolix — same ATC class L02B — Endocrine therapy
- elacestrant — same ATC class L02B — Endocrine therapy
Coverage: 19 decisions for fulvestrant from 7 agencies, 2004 to 2022. Data to 7 Sep 2026. ATC class L02B — Endocrine therapy. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.