The Institute for Clinical and Economic Review (ICER) today released a Final Evidence Report and Report-at-a-Glance on tisagenlecleucel (Kymriah, Novartis) and axicabtagene ciloleucel (Yescarta, Kite Pharma/Gilead), two CAR-T therapies for treatment of B-cell cancers.
ICER’s report was reviewed at a public meeting of the California Technology Assessment Forum (CTAF), where a majority of the panel voted that evidence is sufficient to show that tisagenlecleucel provides a net health benefit for children with B-cell acute lymphoblastic leukemia (B-ALL) and that both tisagenlecleucel and axicabtagene ciloleucel provide a net health benefit for adults with certain B-cell subtypes of non-Hodgkin’s lymphoma (NHL). The two therapies were compared to commonly used chemotherapy regimens for each indication. Evidence was not sufficient to distinguish between the two CAR-T therapies for treatment of NHL.
A majority of the panel further voted that tisagenlecleucel provides intermediate long-term value for money when treating B-ALL. While ICER’s assessment determined that the price of the therapy aligns with its clinical value, the panel noted that the significant uncertainty surrounding the long-term risks and benefits of the therapy precluded a high-value vote.
After deliberating on the value of axicabtagene ciloleucel to treat NHL, the panel’s votes were split between low value and intermediate value, driven by similar concerns about long-term uncertainty.