Lisocabtagene Maraleucel (Breyanzi): CADTH Reimbursement Recommendation [Internet]

Review
Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2022 Jul.

Excerpt

What Is the CADTH Reimbursement Recommendation for Breyanzi?: CADTH recommends that Breyanzi should be reimbursed by public drug plans for the treatment of patients with large B-cell lymphoma (LBCL) if certain conditions are met.

Which Patients Are Eligible for Coverage?: Breyanzi should only be covered to treat patients who have LBCL and have received at least 2 previous treatments that have not worked or have stopped working, as determined by a specialist.

What Are the Conditions for Reimbursement?: Breyanzi should only be reimbursed if patients have not already been treated with a chimeric antigen receptor (CAR) T-cell therapy and are in relatively good health to tolerate the treatment if it is prescribed and administered by specialists and trained personnel in dedicated centres and the cost of Breyanzi is reduced.

Why Did CADTH Make This Recommendation?: Evidence from a clinical trial demonstrated that Breyanzi was associated with clinically meaningful response to treatment and could potentially prolong survival.

Breyanzi would provide an effective alternative option with a potentially different side effect profile for patients with LBCL who need CAR T-cell therapy.

Based on CADTH’s assessment of the health economic evidence, Breyanzi does not represent good value to the health care system at the public list price. The CADTH pCODR Expert Review Committee determined that there is not enough evidence to justify a greater cost for Breyanzi compared with other available CAR T-cell therapies (Kymriah or Yescarta).

Based on public list prices, Breyanzi is estimated to cost the public drug plans approximately $6.8 million over the next 3 years. However, the actual budget impact is uncertain.

What Is LBCL?: LBCL is the most common type of non-Hodgkin lymphoma. A lymphoma, which affects types of white blood cells called lymphocytes, grows primarily in the lymph nodes but it can spread into organs or tissues such as bones, brain, or intestines. It is estimated that 11,400 people living in Canada will be diagnosed with non-Hodgkin lymphoma each year and 3,000 will die.

Unmet Needs in LBCL: Patients with LBCL can be treated with surgery, chemotherapy, radiation, immunotherapy, and stem cell transplant; however, not all patients benefit from available treatments. Some patients may also need further therapy with fewer choices of therapies available to them and have a shorter life expectancy.

How Much Does Breyanzi Cost?: Treatment with Breyanzi is expected to have a 1-time cost of $501,900 per patient. Additional costs associated with pre- and post-infusion management (i.e., leukapheresis, bridging therapy, conditioning chemotherapy) and administration will also apply.

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