Oncologists Are Showing More Enthusiasm for Carvykti Than Are Payers

With its Feb. 28 approval, the Janssen Pharmaceutical Companies of Johnson & Johnson and Legend Biotech USA, Inc.’s Carvykti (ciltacabtagene autoleucel; cilta-cel) becomes the second chimeric antigen receptor T-cell (CAR-T) therapy to treat multiple myeloma. Payers report being less likely to prefer it over some or all other multiple myeloma treatments with a similar indication, but oncologists are showing more enthusiasm for prescribing the new agent, according to Zitter Insights.

The FDA approved Carvykti for the treatment of adults with relapsed or refractory multiple myeloma after at least four lines of therapy, including a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 monoclonal antibody. The product is a B-cell maturation antigen (BCMA)-directed CAR-T agent. The one-time treatment will have a phased launch and will be available through a limited network of certified treatment centers. The FDA gave the drug breakthrough therapy and orphan drug designations. The therapy’s wholesale acquisition cost is $465,000.

The FDA approved the first BCMA-directed CAR-T on March 26, 2021 — Bristol Myers Squibb and bluebird bio, Inc.’s Abecma (idecabtagene vicleucel) — for the same indication as Carvykti. The agency also gave the drug breakthrough therapy and orphan drug designations. The price for the one-time dose is $419,500.

For the Managed Care Oncology Index: Q3 2021, between Aug. 23, 2021, and Oct. 11, 2021, Zitter Insights polled 41 commercial payers covering 113.8 million lives. Those with almost 40% of lives said they were likely to manage Carvykti at parity with other fifth-line multiple myeloma agents (see chart). Abecma was cited as the treatment that payers were likely to prefer it over.

Zitter Insights and AIS Health are both MMIT companies.

The company also surveyed 100 oncologists during the same time frame. Almost 50% said they were likely to prescribe Carvykti over some other fifth-line multiple myeloma treatments, citing GSK’s Blenrep (belantamab mafodotin-blmf), Karyopharm Therapeutics’ Xpovio (selinexor), Oncopeptides’ Pepaxto (melphalan flufenamide) — which the company voluntarily withdrew from the U.S. market in December — and Abecma as the products most likely to be prescribed over. And 43% of respondents said they likely would prescribe it over all other similar treatments for the condition.

For more information on the Zitter Insights data, contact Jill Brown Kettler at jbrown@aishealth.com.