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New HTA Decisions in England
March 2021
Drug name
REVLIMID® (lenalidomide)
Decision date
Therapeutic area
Blood and immune system conditions
Therapeutic sub area
Blood and bone marrow cancers
Recommended with restrictions
Lenalidomide is recommended as maintenance treatment after an autologous stem cell transplant for newly diagnosed multiple myeloma in adults.
Decision Detail
It is recommended only if: • the dosage schedule is 10 mg per day on days 1 to 21 of a 28‑day cycle and; • the company provides lenalidomide according to the commercial arrangement (there is a simple discount patient access scheme for lenalidomide).
The main clinical evidence for lenalidomide maintenance treatment came from Myeloma XI, a phase 3 open-label randomised trial based in 110 NHS centres in the UK. The primary outcomes were progression-free survival and overall survival, both of which were longer with lenalidomide maintenance treatment than with monitoring. The committee agreed that it was appropriate to consider the lower costs of lenalidomide administration that would arise when using 21 day rather than 28 day dosing in NHS practice. When taking this into account, the ICERs were within a range normally considered to be a cost-effective use of NHS resources (below £30,000 per quality-adjusted life year [QALY] gained). Because of confidential discounts for treatments used in the model, ICERs are confidential so cannot be reported here.