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<p>The National Institute for Health and Care Excellence (NICE) is currently evaluating
ciltacabtagene autoleucel, a type of CAR-T therapy, within its marketing authorisation
for relapsed or refractory multiple myeloma. NICE has previously evaluated other CAR-T
therapies such as axicabtagene ciloleucel (Yescarta®) and tisagenlecleucel (Kymriah®)
through its technology appraisal programme.</p><p>NICE’s technology appraisal process
requires the manufacturer or sponsor of the technology under evaluation to produce
an evidence submission that is developed in line with NICE’s preferred methods for
economic evaluation (the “reference case”) as set out in its published manual for
health technology evaluation. The evidence submission is then considered by NICE’s
appraisal committee alongside a critique from an independent academic group and evidence
from other stakeholders such as patients, clinicians and NHS England. During the ongoing
appraisal of axicabtagene ciloleucel for treating relapsed or refractory follicular
lymphoma, NHS England made the committee aware of a single tariff for the delivery
of CAR T-cell therapies. NICE does not hold any information on who NHS England consulted
on the calculation of the tariff.</p><p>NICE’s health technology evaluation manual
states that the reference case “should include the full additional costs associated
with introducing a technology”. The appraisal committee will consider in developing
its recommendations whether the costs that are captured in the evidence submission
appropriately reflect the costs to the National Health Service.</p><p>The committee
papers for previous and ongoing appraisals of CAR-T therapies are available on the
NICE website.</p>
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