
Limited Therapy Access Could Hinder Personalized Cancer Treatment in the UK
The National Institute for Health and Care Excellence recently rejected National Health Service’s funding of Kymriah for diffuse large B-cell lymphoma (DLBCL) despite recognizing that the drug has significant clinical benefits.
Following the European Medicines Agency’s (EMA) approval of Novartis’ Kymriah (tisagenlecleucel) for refractory/relapsed (R/R) diffuse large B-cell lymphoma (DLBCL) in adults in September 2018, the National Institute for Health and Care Excellence (NICE) rejected National Health Service’s (NHS) funding of Kymriah for DLBCL.
According to GlobalData, a data and analytics company, NHS was preparing to embrace the CAR-T cancer treatment, and the company offered a confidential discount on the list price of £282,000 (US$372,000). However, the discounted price was still above the range that NICE considers an acceptable use (no more than £50,000 per year, or US$66,000) of NHS funds on an end-of-life drug.
NICE based its decision on the lack of data comparing Kymriah to the gold-standard chemotherapy and concluded that Kymriah is not cost-effective for routine NHS funding or use within the Cancer Drugs Fund, GlobalData reports.
In contrast, in September 2018, NICE gave the green light to Kymriah for patients with R/R B-cell acute lymphoblastic leukemia (ALL) up to 25 years old, a much smaller market, within 10 days after it obtained marketing authorization from EMA.
“NICE’s rejection of Kymriah for DLBCL does not come as a complete surprise after a series of dismissals of other immune-oncology drugs for regular NHS funding, including Gilead/Kite’s Yescarta (axicabtagene ciloleucel) in R/R DLBCL and R/R primary mediastinal large B-cell lymphoma,” said Dr Edit Kovalcsik, managing analyst at GlobalData, in a Sept. 25, 2018 press release. “Amid the uncertainty of access to new cancer drugs, on the other hand, the UK is keen to become a global hub in biotherapeutics.”
According to GlobalData’s report,
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