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Draft guidance consultation

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1 Recommendations

1.1

Epcoritamab should not be used to treat relapsed or refractory follicular lymphoma in adults after 2 or more lines of systemic treatment.

1.2

This recommendation is not intended to affect treatment with epcoritamab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.

What this means in practice

Epcoritamab is not required to be funded and should not be used routinely in the NHS in England for the condition and population in the recommendations.

This is because there is not enough evidence to determine whether epcoritamab is value for money in this population.

Why the committee made these recommendations

Usual treatment for relapsed or refractory follicular lymphoma after 2 or more lines of systemic treatment includes various combinations of chemotherapy and rituximab-based treatment.

There is an ongoing clinical trial that does not compare epcoritamab with any other treatments. Indirect comparisons suggest that epcoritamab increases how long people have before their condition gets worse and how long people live compared with usual treatment. But these results are uncertain because the epcoritamab and usual treatment studies were designed differently and included different populations.

The economic model is also uncertain because of the assumptions used to model usual treatment.

Because of the uncertainties in the economic model and clinical evidence it is not possible to determine the most likely cost-effectiveness estimates for epcoritamab. So, epcoritamab should not be used.