23 March 2021

Triple Therapy Recommended by NICE for Patients with Multiple Myeloma

The therapy has been recommended after a confidential discount was agreed between NHS England and the drug manufacturer Amgen.

A new second line triple therapy is to be offered to NHS patients in England with multiple myeloma after NICE recommended its use.

Carfilzomib with dexamethasone and lenalidomide could be offered to around 2,000 patients with multiple myeloma who have had at least one previous therapy, which include bortezomib.

Clinical trial evidence shows that carfilzomib with lenalidomide and dexamethasone gives longer periods of remission and people live longer, compared with the current second line treatment lenalidomide plus dexamethasone.

Evidence seen by NICE’s independent appraisal committee shows the benefit of the triple therapy treatment appears to continue for up to six years. There is uncertainty about how long the benefit lasts after this.

The committee believes the most likely cost-effectiveness estimates are within what NICE normally considers a cost-effective use of NHS resources.

The therapy has been recommended after a confidential discount was agreed between NHS England and the drug manufacturer Amgen.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: “The recommendation of our committee will be welcomed by people with multiple myeloma who have told us of the need of a new second line treatment option that gives longer periods of remission and improves survival.

“The clinical data shows that the benefits of this triple therapy continue after treatment has stopped.  A positive decision has been made possible after the company and NHS England came to a commercial arrangement which allows carfilzomib to be used on the NHS with a confidential discount.”

Professor Peter Johnson, NHS England Clinical Director for Cancer, said: “Even as we continue to care for Covid-19 patients, it is vital that we continue to innovate and offer cancer patients the best available treatments, which is why the NHS has worked hard to reach this agreement for carfilzomib which can extend the lives of those with multiple myeloma.

“It provides doctors another option to treat this disease and gives patients hope when alternative treatments haven’t worked, ensuring the NHS can continue to give first-class care to patients.”

Carfilzomib is administered by intravenous injection. One 60-mg vial has a list price of £1,056 plus VAT. The drug's manufacturer, Amgen, has agreed a confidential commercial agreement with the NHS to allow its use at a discounted price.

NHS patients will be offered a maximum of 18 cycles of treatment in accordance with the guidance.