The recently announced Gilead deal with the NHS which will allow some adult NHS patients suffering from large B-cell lymphoma (DLBCL) to gain access to its CART-T cell therapy, Yescarta, will place the UK among the first countries in the world to offer this new generation of personalized medicine to cancer patients, observes GlobalData, a leading data and analytics company.
However, its availability will be limited.
According to GlobalData’s report, ‘EpiCast Report: Non-Hodgkin’s Lymphoma – Epidemiology Forecast to 2024’, around 5000 patients are diagnosed with DLBCL in the UK each year, but as Dr Edit Kovalcsik, Managing Analyst at GlobalData noted, “Yescarta is expected to be available for a limited number of adult patients with large B-cell lymphoma, benefiting no more than 200 patients per year.’’
The initial rejection for NHS funding by NICE of the EMA-approved Yescarta for adult use in refractory/relapsed (R/R) DLBCL and R/R primary mediastinal large B-cell lymphoma (PMBCL), was due to Gilead’s formerly proposed price being deemed too high by NICE to be considered a cost-effective use of NHS resources.
Chloé Thépaut, MRes, Oncology and Hematology Senior Analyst at GlobalData comments, “I had anticipated the issues with reimbursement and pricing of CAR-T therapies to be key hurdles for European uptake of CAR-T cells. Companies may need to consider lower price points or consider pay-for-performance arrangements to introduce their products to the European market.
“The low number of centers in the EU with CAR-T cell manufacturing capabilities will also be a hurdle to uptake of CAR-T cell therapy.”
In order to overcome these issues, researchers at Imperial College London are designing a new generation CAR-T cell therapy, which utilizes genetically engineered natural killer T-cells (NKT), which, unlike CAR-T cells, do not have to be derived from the patient’s own immune cells.
Kovalcsik concludes, “This national effort to improve access to CAR cell treatment by developing an ‘off-the-shelf’ CAR cell therapy enabling faster and cheaper manufacturing, could be a sustainable solution to reduce cost whilst providing optimal care for patients with cancer in the UK.”
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