NICE refuses to recommend Kymriah to treat diffuse large B-cell lymphoma.- Novartis

The National Institute for Health and Care Excellence (NICE), in a draft ruling, has rejected Kymriah (tisagenlecleucel) 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, NICE has chosen not to fund the treatment for adults with DLBCL.

NICE stated that the CAR-T therapy was too expensive while noting a lack of comparative data and the high degree of side effects. 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. NICE says the committee will consider comments received on the draft guidance, together with any new evidence, at its next meeting on 23 October 2018.

The reviewing committee also said Novartis did not make the case for Kymriah to be included in the Cancer Drugs Fund.