Fredrik Schjesvold, Head of Oslo Myeloma Center at Oslo University Hospital, shared a post on LinkedIn:
“Today there was a new “no” to cilta-cel in Norway.
Even though both Denmark and Sweden have approved it, with their measure of cost-effectiveness, this isn’t sufficient for Norway.
Other countries that have approved it on a general basis to their population are: Austria, Switzerland, Belgium, Germany, Ireland, Luxembourg, Portugal and Spain.
So what are the stated reasons? It was the two reasons all denied therapies get.
- ‘The price is not reasonable for the benefit.’
- ‘Uncertain documentation.’
Well, I’m not so sure.
Even though the price is unknown, we know the price in Germany (because Norwegian patients buy it there). The alternative is a continuous treatment in Norway with expensive drugs lasting a median of 3 years. The price for these 3 years is about the same as cilta-cel bought in Germany. However since continuous treatment is very work-heavy for hospital doctors and nurses, it is probably in total more expensive, because after cilta-cel there are many years without any treatment. Not even accounting for the significant number of patients that probably will be cured in second line, not costing Norway any more myeloma treatment.
And what about documentation? This is based on a large phase-3 trial, with early and large overall survival benefit. How much better can documentation get? None of the regimens they have compared with have any overall survival benefit.
So how did this happen? The answer is the same as always. There is no communication with expertise on the disease, leading to similar mistakes as last year for Blenrep. At the same time we see the real valuation of saved quality-adjusted life-years going down every year in Norway, and the hospitals expenses on drugs also gradually going down (now it’s 5-6%, some years ago it was 6-7%).
To sum it up. Without discussing this with experts on the disease, they are saying no to the best approved treatment ever made for myeloma, with a large and early overall survival benefit (which the comparators don’t have) and a potential to cure a significant number of patients. And it probably doesn’t even cost more.”
Title: J and J after Carvykti-no: – Difficult to accept J and J after Carvykti-no: – Difficult to accept
Author: Hans Anderssen
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