Health technology appraisals – Summer 2025 update

Maddie Dichiu
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The myeloma treatment pathway continues to evolve and expand with the recent National Institute of Health and Care Excellence (NICE) approval of belantamab mafodotin (Blenrep®) in combination with bortezomib (Velcade®) and dexamethasone (BVD) and 10 active health technology appraisals across NICE and the Scottish Medicines Consortium (SMC).

Recent approvals: Recommended by NICE

  • Belantamab mafodotin, bortezomib and dexamethasone (BVD) for relapsed or refractory myeloma patients who have had one previous treatment and are refractory to or can’t tolerate lenalidomide (Revlimid®). Read more about the approval of BVD here.

Forward look: NICE 

  • Isatuximab (Sarclisa®), pomalidomide (Imnovid®) and dexamethasone

The reappraisal for isatuximab with pomalidomide and dexamethasone (IsaPD) is still ongoing with the third committee meeting due to take place later this year. In the meeting, the committee will discuss the outcome of the appeal and review the cost-effectiveness of IsaPD before making their final decision about routine commissioning. 

The treatment remains available and can be offered to patients not currently on IsaPD whilst the appraisal is ongoing. You can read more about the earlier appeal to review IsaPD for use on the NHS here. 

  • Belantamab mafodotin, bortezomib and dexamethasone 

NICE approved the use of belantamab mafodotin with bortezomib and dexamethasone (BVD) in June 2025. However, the decision was published as draft guidance because NICE’s recommendation was narrower than the licenced indication for BVD, limiting its use to second line and for lenalidomide refractory or unsuitable patients only. As a result, the appraisal is ongoing to allow sufficient consultation on the proposed usage restrictions. The committee will reconvene in November 2025 to review any additional evidence and discuss whether the restrictions, particularly the lenalidomide based restrictions, should be removed.  

  • Belantamab mafodotin, pomalidomide and dexamethasone 

NICE is appraising the use of belantamab mafodotin, pomalidomide and dexamethasone (BPD) for relapsed or refractory myeloma patients who have had one or more previous treatments. The NICE committee meeting for the appraisal took place in January 2025 and NICE published a preliminary decision not to recommend BPD for use on the NHS in June. The second committee meeting to review the draft decision will take place later this year.  

  • Isatuximab, bortezomib, lenalidomide and dexamethasone 

NICE is appraising the use of isatuximab with bortezomib, lenalidomide and dexamethasone (Isa-VRD) for newly diagnosed myeloma patients who are not eligible for stem cell transplantation (SCT). If approved, this combination treatment will be the first quadruplet for patients who can’t have a SCT. Earlier this year NICE published draft guidance not recommending the treatment because it was not considered cost-effective use of NHS resources. The preliminary decision was reviewed at a second committee meeting in July, and we expect that the final decision will be published soon. 

  • Talquetamab (Talvey®) monotherapy 

NICE is appraising the use of talquetamab monotherapy for relapsed and refractory myeloma patients who have had three or more lines of treatment including an immunomodulatory drug, a proteosome inhibitor and an anti-CD38 antibody. If approved by NICE will be the first GPRC5D-directed myeloma treatment in the UK. Myeloma UK submitted evidence for this appraisal in March 2025 and will attend the first committee meeting on 12 August 2025. 

  • Daratumumab (Darzalex®), bortezomib, lenalidomide and dexamethasone 

NICE is appraising the use of daratumumab with bortezomib, lenalidomide and dexamethasone (DVRD) for newly diagnosed myeloma patients who are not eligible for SCT. Myeloma UK submitted evidence for this appraisal in July and will attend the first committee meeting in December 2025. 

  • Daratumumab, bortezomib, lenalidomide and dexamethasone 

NICE is appraising the use of daratumumab with bortezomib, lenalidomide and dexamethasone (DVRD) for newly diagnosed myeloma patients who are eligible for stem cell transplantation. Myeloma UK submitted evidence for this appraisal in July and will attend the first committee meeting in December 2025. If approved by NICE it will give newly diagnosed patients access to the first minimal residual disease (MRD) tailored treatment regimen.  

Forward look: SMC 

  • Belantamab mafodotin, bortezomib and dexamethasone 

The SMC is appraising the use of belantamab mafodotin, bortezomib and dexamethasone (BVD) for relapsed or refractory myeloma patients who have had one or more previous treatment. Myeloma UK has submitted evidence for this appraisal and will attend the Patient and Clinician Engagement meeting for BVD in August and the committee meeting in September 2025.  

  • Belantamab mafodotin, pomalidomide and dexamethasone 

The SMC is appraising the use of belantamab mafodotin, pomalidomide and dexamethasone (BPD) for relapsed or refractory myeloma patients who have had one or more previous treatment. Myeloma UK has submitted evidence for this appraisal and will attend the Patient and Clinician Engagement meeting for BPD in August and the committee meeting in September 2025. 

  • Isatuximab, bortezomib, lenalidomide and dexamethasone 

The SMC is appraising the use of isatuximab with bortezomib, lenalidomide and dexamethasone (Isa-VRD) for newly diagnosed myeloma patients who are not eligible for stem cell transplantation. Myeloma UK will submit evidence for this appraisal in August 2025. 

If you would like more information on HTA processes, upcoming treatment appraisals, or Myeloma UK’s access work, contact the Policy Team. 

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