Ravulizumab: 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
AWMSG (Wales), HIRA (South Korea) and NICE (England), among others, recommended or restricted ravulizumab, while AOTMIT (Poland), CIPM (Spain) and DMC (Denmark), among others, did not recommend it.
On the same population the two systems disagree outright: NICE (England) recorded recommended in TA698, while PBAC (Australia) recorded not recommended for “Paroxysmal nocturnal haemoglobinuria (PNH)”.
AOTMIT (Poland) has been harder on ravulizumab than on its own caseload: it refused 6 of 6 decisive submissions here (100%), against a base rate of 41% across everything it has assessed.
Assessment has run over 6.9 years, from 28 Aug 2019 at CHUIKYO (Japan) to 24 Jul 2026 at AOTMIT (Poland).
PBAC (Australia) changed its position: not recommended in 2020, recommended by 2025, after a resubmission.
No assessment is on file from PHARMAC (New Zealand) and TLV (Sweden), each among the eight highest-volume agencies here.
Not every gap is a refusal: for ravulizumab, 2 submissions were never made and 2 were withdrawn or terminated before a decision — an outcome set by the company rather than the assessor.
The file is active: 30 of 54 records date from 2023 or later.
Against its own class, ravulizumab is an outlier: 53% of its decisive outcomes were positive, where molecules sharing ATC class L04A average 78%.
The programme is broad: 17 distinct indication wordings are recorded for ravulizumab by the agencies that label one in English (AWMSG, NICE, PBAC and SMC).
9 of these 54 records carry a year of decision but no day, so any interval quoted here is approximate to within a year.
CHUIKYO (Japan) was first to assess ravulizumab, on 28 Aug 2019; DMC (Denmark) did not open a file until 29 Apr 2026 — a wide spread of 6.7 years between the earliest and latest system to look at it.
The record arrives in waves: 7 separate years each carry two or more decisions, spread across 8 years in total.
11 of the 15 agencies here assessed ravulizumab more than once, PBAC (Australia) most often at 9 entries — repeat review is the norm for this molecule rather than the exception.
ravulizumab has been through 15 of the 18 agencies in this archive — among the most widely assessed molecules on file.
The full ledger for ravulizumab reads 16 not recommended, 13 recommended, 6 no benefit and 5 restricted, with 14 in other categories.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| DMC (Denmark) | 29 Apr 2026 | Behandling af voksne patienter med NMOSD, som er anti-aquaporin 4(AQP4)-antistofpositive | Ikke anbefalet | source |
| ZIN (Netherlands) | 8 Dec 2025 | Advies - vergoed ravulizumab (Ultomiris®) voor de behandeling van de bloedziekte aHUS | reimbursed with conditions (sluis) | source |
| NYE METODER (Norway) | 27 Apr 2025 | Behandling av voksne med generalisert myasthenia gravis. | decision recorded | source |
| PBAC (Australia) | 2024 | Generalised myasthenia gravis (gMG) | Not Applicable | source |
| CONITEC (Brazil) | 7 Mar 2024 | Tratamento de pacientes com hemoglobinúria paroxística noturna a partir de 14 anos de idade, virgens de tratamento ou em… | incorporated into SUS | source |
49 further decisions for ravulizumab, across 14 agencies, are not shown here. They include the most recent record on file, 24 Jul 2026 from AOTMIT (Poland); its outcome is in the subscriber dataset. They link to 37 further source documents.
Related molecules
- zilucoplan — divergent outcome (not recommended vs recommended) on a shared indication
- efgartigimod alfa — divergent outcome (not recommended vs recommended) on a shared indication
- rozanolixizumab — divergent outcome (not recommended vs recommended) on a shared indication
- adalimumab — same ATC class L04A — Immunosuppressants
- upadacitinib — same ATC class L04A — Immunosuppressants
- secukinumab — same ATC class L04A — Immunosuppressants
Coverage: 54 decisions for ravulizumab from 15 agencies, 2019 to 2026. Data to 7 Sep 2026. ATC class L04A — Immunosuppressants. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.