Teclistamab (Tecvayli): CADTH Reimbursement Recommendation: Indication: For the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least 3 prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody, and who have demonstrated disease progression on the last therapy

What is the cadth reimbursement recommendation for tecvayli?CADTH recommends that Tecvayli (teclistamab) be reimbursed by public drug plans for the treatment of adults with relapsed or refractory (r/r) multiple myeloma (MM) who have received at least 3 prior lines of therapy, including a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and an anti-CD38 monoclonal antibody (mAb), and who have demonstrated disease progression on the last therapy if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Tecvayli should only be covered to treat adults with MM who have received at least 3 prior treatments, have disease that has not responded to their last treatment, and are in relatively good health. Tecvayli should not be reimbursed to treat those whose MM is affecting their brain or spinal cord or those showing signs that the tissue layers protecting the brain and spinal cord are affected by MM. It also should not be reimbursed in those with amyloidosis (a buildup of a protein, amyloid, in organs) that is not secondary to MM, and those with plasma cell leukemia. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Tecvayli should only be reimbursed if it is prescribed and administered by health professionals at treatment centres with adequate medical resources and personnel. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from a clinical trial demonstrated that Tecvayli may result in response to treatment, delay the time to disease progression, and allow patients to live longer. Tecvayli may meet some patient needs because it may be an effective treatment option with manageable side effects. Based on CADTH’s assessment of the health economic evidence, Tecvayli does not represent good value to the health care system at the public list price. A price reduction is therefore required. Based on public list prices, Tecvayli is estimated to cost the public drug plans approximately $180 million over the next 3 years.Additional informationWHAT IS MM? MM is a cancer of plasma cells (i.e., white blood cells) in the bone marrow (i.e., the soft matter inside bones where blood cells are made). Approximately 4,000 people in Canada were diagnosed with MM in 2022. UNMET NEEDS IN MM: MM is an incurable disease with a poor prognosis. MM often does not respond to initial treatments and will relapse, so the patient will need to try many different treatments. There is a need for additional treatment options that prolong survival, delay disease progression, improve quality of life, and reduce side effects. HOW MUCH DOES TECVAYLI COST? Treatment with Tecvayli is expected to cost approximately $29,608 per patient for the first 28 days on treatment and $26,964 per patient for all 28-day cycles thereafter.