Interventions of Interest:
- idecabtagene vicleucel (Abecma®, Bristol-Myers Squibb, bluebird bio)
- ciltacabtagene autoleucel (Johnson & Johnson, Legend Biotech Corp)
- Belantamab mafodotin (Blenrep™, GlaxoSmithKline)
The Midwest CEPAC unanimously determined the evidence is adequate to demonstrate that CAR-T treatments ide-cel and cilta-cel both provide a net health benefit when compared to usual care; despite these benefits, for ide-cel, the only CAR-T agent having received FDA approval at this time, a majority of panelists voted that it represents “low” long-term value for money at current pricing.
For belantamab, the majority of the committee found the evidence was not adequate to demonstrate a net health benefit, and the committee unanimously voted that belantamab’s long-term value for money is “low” at current pricing.
“Many people with multiple myeloma develop resistance to existing treatments, so these three new therapies with new mechanisms of action represent a very important expansion of the clinical options available to patients and oncologists. Data are extremely limited at this time for the two CAR-Ts, and important evidence gaps remain to be filled, but having a new innovative approach become available for patients with multiple myeloma is something to celebrate. Shadowing these new treatments are concerns that the pricing for the first approved CAR-T agent in multiple myeloma exceeds a reasonable level for its given benefit. Manufacturers should restrain their pricing and work with payers to ensure that payment mechanisms and overall benefit coverage can help patients from all walks of life get affordable access to these treatments.
“Belantamab appears to deliver more modest overall clinical benefit, but clinical experts believe it too will have a role in therapy. At its current pricing, belantamab appears to meet commonly cited thresholds for cost-effectiveness, but our independent appraisal committee determined that its long-term value for money was ‘low’ due to questions about the magnitude of overall survival benefit and certain favorable assumptions within the economic model.”