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NICE rejects CAR-T therapy Kymriah for DLBCL in adults

Published on 19/09/18 at 11:31am

The National Institute for health and Care Excellence (NICE) has rejected Novartis’ CAR-T therapy Kymriah for use in adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

While Kymriah was approved for use in children and young adults up to the age of 25 years old with B-cell acute lymphoblastic leukaemia (ALL) that is refractory, in relapse post-transplant or in second or later relapse, earlier this month; the cost effectiveness body have chosen not to fund the Swiss multinational’s treatment for adults with DLBCL.

The committee suggested that the CAR-T therapy was too expensive while noting lack of comparative data and the high degree of side effects, in explaining their decision.

Meindert Boysen, Director of the Centre for Health Technology Evaluation at NICE commented: “Although we could not recommend tisagenlecleucel-T for adults with lymphoma, we welcome further discussions around the cost-effectiveness of the treatment and engagement with stakeholders.”

She continued: “The company had offered a confidential discount on the list price of £282,000, however, the cost-effectiveness estimates were still above the range that NICE considers an acceptable use of NHS resources”

Dr Alasdair Rankin, director of Research and Patient Experience at blood cancer charity Bloodwise also offered insight in suggesting that: “CAR-T therapies are expensive and while there have been hugely promising early results in clinical trials, long-term survival rates are not known for certain because it is such a new technology.”

He added that: “By approving CAR-T therapy to treat childhood leukaemia on the Cancer Drugs Fund earlier this month and investing in the infrastructure needed to make it available, the NHS has made it clear that it is willing to take a chance on these life-saving cancer treatments if enough evidence is available and a price can be agreed.”

“People with diffuse large B-cell lymphoma who relapse after multiple treatments have a very poor outlook if they are treated again with chemotherapy. We hope the concerns and questions around CAR-T can be addressed so that these patients can be given access to the chance of a cure.”

Louis Goss

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