The Scottish Medicines Consortium (SMC) has today (11 February 2019) announced that the CAR T-cell therapy axicabtagene ciloleucel (Yescarta®) is not recommended for use within NHS Scotland for the treatment of adults with diffuse large B cell lymphoma (DLBCL) or primary mediastinal large B cell lymphoma (PMBCL) that has not responded (refractory) or has come back (relapsed) after two or more previous treatments.
SMC decided that the evidence submitted by Kite Pharma, the company that manufactures axicabtagene ciloleucel, was not strong enough to be certain that axicabtagene ciloleucel offers value for money to NHS Scotland.
CAR T-cell therapy offers a potential lifeline for people with relapsed or refractory DLBCL or PMBCL, who otherwise have extremely limited treatment options. During the SMC appraisal process, Lymphoma Action advocated for access to the treatment for people who need it so this decision not to make it available is disappointing.
Axicabtagene ciloleucel was recently approved by NICE for treatment on the NHS in England and Wales and so we are particularly disappointed that the SMC’s decision causes inequality of access to this new treatment within the UK.
The SMC is due to announce whether tisagenlecleucel (Kymriah®), another CAR T-cell therapy, will be available in Scotland for people with relapsed or refractory DLBCL on 11 March. It has already approved Kymriah® for the treatment of children and young adults with relapsed or refractory B-cell acute lymphoblastic leukaemia (ALL).