the company provides brentuximab vedotin according to the commercial arrangement.
1.2 These recommendations are not intended to affect treatment with brentuximab vedotin that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.
Why the committee made these recommendations
Brentuximab vedotin is licensed to treat CD30-positive CTCL after at least 1 systemic therapy. It is most likely to be used in the NHS as an alternative to systemic treatments to treat advanced disease. At this point in the pathway, current treatment options include methotrexate, bexarotene and interferon alfa.
Clinical trial evidence shows that brentuximab vedotin is better than methotrexate or bexarotene in terms of response rates and extending how long people live without their disease getting worse. For some people with CTCL, brentuximab vedotin will be used as a bridge to a stem cell transplant.
The most plausible cost-effectiveness estimates for brentuximab vedotin compared with current treatments are less than £30,000 per quality-adjusted life year gained, which is within the range considered to be a cost-effective use of NHS resources. However, these estimates are based on data from people with specific subtypes of advanced disease (mycosis fungoides stage IIB or over, primary cutaneous anaplastic large cell lymphoma and Sézary syndrome), so brentuximab vedotin is only recommended for these subtypes.