Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact on patients with relapsed or refractory Mantle Cell Lymphoma of NICE’s draft decision not to recommend brexucabtagene autoleucel (Tecartus) for NHS use; and whether he plans to review the CAR‑T delivery tariff to ensure continued access to treatments.

The National Institute for Health and Care Excellence (NICE) is currently re-evaluating brexucabtagene autoleucel to determine whether it can be recommended for routine National Health Service funding following a period of managed access through the Cancer Drugs Fund. NICE’s draft guidance, published in December, does not recommend it as a clinically and cost-effective use of NHS resources. The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients with mantle cell lymphoma will be concerning for patients and their families, but it is right that these decisions are taken independently and on the basis of the available evidence. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.

The CAR-T delivery tariff reflects the costs which the NHS incurs for delivering CAR-T therapy. The tariff was updated for the start of the 2024/25 financial year following a planned costing review involving all CAR-T providers in England. This enabled the tariff to be updated with the benefit of the significant delivery experience that can be drawn on having first routinely introduced CAR-T in the NHS in 2023. Other than considering an appropriate inflationary uplift on an annual basis, in line with usual practice, there are no plans to further review the tariff at this time. Other CAR-T therapies have been recommended for routine NHS adoption in England by NICE based on an assessment of clinical and cost effectiveness that reflects the existing CAR-T delivery tariff, most recently obecabtagene autoleucel for acute lymphoblastic leukaemia.