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NHS chief pledges CAR-T support, but asks for pricing restraint

The plea comes as the EMA reviews two CAR-T therapies


NHS England chief executive Simon Stevens has said that new CAR-T therapies for cancer could become available to NHS patients this year, and preparations are ongoing to deliver them to eligible patients.

The NHS recognises these are “ground-breaking” new treatments with the potential to transform the treatment of cancer, Stevens told the Association of the British Pharmaceutical Industry (ABPI) conference yesterday. However, the companies developing them must set “fair and affordable prices so treatments can be made available to all who need them”.

The comments were immediately welcomed by blood cancer charity Bloodwise, which said that making CAR-Ts available will be “a really positive step for some people living with cancer whose lives cannot be saved using the treatments doctors can already provide”.

Bloodwise’s research director Dr Alasdair Rankin echoed Stevens’ plea on pricing, saying that “It is also vital that this new treatment does not take NHS resources away from the many thousands of people with blood cancer for whom it won’t be appropriate”.

The comments come as the EMA is reviewing marketing applications for the two CAR-T therapies from Novartis and Kite Pharma/Gilead that have already been approved by the US FDA and are heading for a verdict in the EU in the coming weeks.

Kite’s CAR-T Yescarta (axicabtagene ciloleucel) was the first to be submitted for approval in Europe and is being reviewed by the EMA for diffuse large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBCL) and transformed follicular lymphoma (TFL). Meanwhile, Novartis’ Kymriah (tisagenlecleucel) has been filed for B-cell acute lymphoblastic leukaemia (ALL) and DLBCL.

Both have also been referred to the National Institute for Health and Care Excellence (NICE) for cost-effectiveness assessment.

Rankin indicated Stevens’ comment about preparation is important, as other factors other than price must come into play if these new therapies are to be used effectively.

CAR-T is a new approach to immuno-oncology that uses harvested and modified versions of a patient's own white blood cells to attack cancer, homing in on tumour-associated antigens. In the future it may be possible to use ‘off-the-shelf’ donor cells that will simplify the procedure, but even if that occurs, providing CAR-T will require significant healthcare support, not least because of the risk of side effects from the procedure such as cytokine release syndrome (CRS) and neurotoxicity.

Implementing CAR-T properly “will require more than just cash funding, as in order to administer this type of treatment the NHS will need to provide many more intensive care beds plus significant additional nursing support”, said Rankin.

Article by
Phil Taylor

27th April 2018

From: Sales



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