WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR YESCARTA?: CADTH recommends that Yescarta be reimbursed by public drug plans for the treatment of adult patients with relapsed or refractory follicular lymphoma (FL) if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Yescarta should only be covered to treat adult patients who have grade 1, 2, or 3a FL and whose disease has returned following second-line treatment or later lines of treatments. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Yescarta should only be reimbursed for patients who have not already received a chimeric antigen receptor (CAR) T-cell therapy and are in relatively good health, and if the cost of Yescarta is reduced. Yescarta should be prescribed and administered by clinicians with expertise in blood cancers in a hospital setting with adequate resources to treat patients and manage side effects. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from a clinical trial suggested that treatment with Yescarta results in maintained tumour shrinkage and may improve the average length of time patients are alive after starting treatment. In addition, treatment with Yescarta may improve the length of time until the cancer grows or spreads, or until death. Yescarta may be an effective treatment option for patients who have received multiple unsuccessful therapies and are seeking new treatments that may prolong survival. Based on CADTH’s assessment of the health economic evidence, Yescarta does not represent good value to the health care system at the public list price. A price reduction is therefore required. Based on public list prices, Yescarta is estimated to cost the public drug plans approximately $210,586,531 over the next 3 years.

ADDITIONAL INFORMATION

WHAT IS FL? FL is a common type of non-Hodgkin lymphoma that develops when the body makes abnormal white blood cells (WBCs). In FL, the abnormal WBCs cluster together to form lumps in lymph nodes or other tissues. FL tends to progress slowly over many years; however, patients whose FL does not respond to treatment or whose FL returns after responding to previous treatments have a shortened life expectancy. It is estimated that 1 in 3,000 people have FL. UNMET NEEDS IN FL: Patients with FL whose cancer does not respond to treatment or whose cancer returns after treatment have a poor prognosis and limited treatment options. Further, not all patients benefit from the limited treatments that are available. Therefore, there is a need for additional treatments that can prolong survival, cure the disease, and improve quality of life. HOW MUCH DOES YESCARTA COST? Treatment with Yescarta is expected to cost approximately $485,000 per infusion.