NICE now approves Kymriah for treatment of diffuse large B-cell lymphoma on NHS.- Novartis

The National Institute for Health and Care Excellence (NICE) has changed its opinion and approved T-cell (CAR T-cell) therapy Kymriah (tisagenlecleucel) from Novartis for treatment of adults with diffuse large B-cell lymphoma (DLBCL). Kymriah is the only CAR-T cell therapy available for NHS patients for two distinct blood cancers and it will now be available to eligible adults who did not respond to two or more previous treatments with DLBCL. The recommendation is based on data from the pivotal JULIET trial, an ongoing study which demonstrated median probabilities of 64% of patients being relapse-free and 43% overall survival at 18 months in patients with the relapsed/refractory disease.

Comment: NICE had previously 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, but the cost-effectiveness estimates were still above the range that NICE considered acceptable. Further negotiations between NHS England and the company led to a commercial agreement offering the therapy at a lower price.