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NHS England’s commercial deal with the manufacturer Novartis is the first in Europe, and comes less than 10 days after the treatment was granted its European marketing authorisation. It represents one of the fastest funding approvals in the 70 year history of the NHS.
The landmark deal means young people with a form of leukaemia are set to receive CAR-T (a chimeric antigen receptor T-cell) therapy within weeks, after NICE also green-lighted the treatment for entry into the reformed NHS Cancer Drugs Fund.
The Tisagenlecleucel form of CAR-T, also known as Kymriah, is the first in a wave of treatments in a new era of personalised medicine and part of the NHS’s long term plan to upgrade cancer services.
Unlike other forms of treatment, CAR-T therapy is specifically developed for each individual patient and involves reprogramming the patient’s own immune system cells which are then used to target their cancer. It has been shown in trials to cure some patients, even those with advanced cancers where other treatments have failed.
Announcing the deal at Health Innovation Expo in Manchester, Simon Stevens, chief executive of NHS England, will say: “CAR-T therapy is a true game changer, and NHS cancer patients are now going to be amongst the first in the world to benefit. Today’s approval is proof-positive that, in our 70th year, the NHS is leading from the front on innovative new treatments. This constructive fast-track negotiation also shows how responsible and flexible life sciences companies can succeed – in partnership with the NHS – to make revolutionary treatments available to patients.”
Tisagenlecleucel, which costs around £282,000 per patient at its full list price, is licenced to treat patients up to 25 years old with B cell acute lymphoblastic leukaemia (ALL) that is refractory, in relapse post-transplant or in second or later relapse. Patients in trials had an average age of 11.
The process of producing such a treatment is immensely complex and preparations are in their final stages. The first three NHS hospitals to go through the international accreditation process for the provision of CAR-T therapy for children are in London, Manchester and Newcastle. Subject to passing accreditation requirements the first treatments could begin in a matter of weeks.
Cancer survival in this country is now at an all-time high with 7,000 more people surviving cancer compared with three years ago, and the NHS is playing a leading role in the development and adoption of cutting edge technology in a new era of personalised medicine. So far, CAR-T has only been available to patients in Europe through clinical trials.”
Leukaemia Care response to NHS England announcement:
Zack Pemberton-Whiteley, Campaigns and Advocacy Director at Leukaemia Care, said:
“This announcement marks a significant advance for children with leukaemia. CAR-T is a specific type of immunotherapy that involves collecting and using the patient’s own immune cells to target the cancer. The potential of CAR-T therapy is promising, with the potential to cure children who have exhausted most alternative treatments. However, it must be remembered that CAR-T is not without risks and can have significant side effects.
We commend NHS England, NICE and Novartis for working closely to provide access for patients through the Cancer Drugs Fund, in the first CAR-T access deal in Europe. The first treatments could begin in a matter of weeks, offering hope to those who desperately need it.”
Video: Zack discusses CAR-T at EHA 2018
Toolkit available on Car-T here