Latest news: Health technology appraisals – Winter 2025/2026

There has been a lot of activity in recent months with two committee meetings for DVRD – the quadruplet comprised of daratumumab (Darzalex®), bortezomib (Velcade®), lenalidomide (Revlimid®) and dexamethasone – and another for IsaPD – isatuximab (Sarclisa®), pomalidomide (Imnovid®) and dexamethasone. This has taken place alongside three approvals across the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC).

Recent approvals

Recommended by NICE

• Belantamab mafodotin (Blenrep®), pomalidomide and dexamethasone (BPD) for myeloma patients who have received one previous line of treatment including lenalidomide. Read more about this approval here.
• Talquetamab (Talvey®) as 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. Read more about the approval and use of talquetamab here.

Recommended by SMC

• Isatuximab, bortezomib, lenalidomide and dexamethasone (IsaVRD) for newly diagnosed myeloma patients who are not eligible for stem cell transplantation. Read more about approval of IsaVRD in Scotland here.

Forward look: NICE

Belantamab mafodotin, bortezomib and dexamethasone (BVD)

NICE approved the use of belantamab mafodotin with bortezomib and dexamethasone 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 However, the decision was published as draft guidance because NICE’s recommendation was narrower than the licenced indication for BVD, limiting its use to second line and for lenalidomide refractory or unsuitable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 reconvened in September 2025 to review any additional evidence and discuss whether the lenalidomide-based restrictions should be removed. We expect that the final decision on the use of BVD will be published in February 2026.

Daratumumab, bortezomib, lenalidomide and dexamethasone (DVRD)

• For patients who are not eligible for stem cell transplantation (SCT)

NICE is appraising the use of daratumumab with bortezomib, lenalidomide and dexamethasone for newly diagnosed myeloma patients who are not eligible for stem cell transplantation (SCT).

Myeloma UK submitted evidence for this appraisal in July and attended the first committee meeting in December 2025. In January, NICE published a ‘draft no’, not recommending DVRD. The decision will be reviewed at a second committee meeting in March 2026.

• For newly diagnosed myeloma patients who are eligible for stem cell transplantation

NICE is also appraising the use of DVRD for newly diagnosed myeloma patients who are eligible for stem cell transplantation. If approved by NICE, it will give newly diagnosed patients access to the first minimal residual disease (MRD) tailored treatment regimen.

Myeloma UK submitted evidence for this appraisal in July and attended the first committee meeting in December 2025. In January, NICE published a ‘draft no’, not recommending DVRD. This decision will also be reviewed at a second committee meeting in March 2026.

You can read more about both ‘draft no’ decisions for DVRD here.

Isatuximab, pomalidomide and dexamethasone (IsaPD)

The reappraisal for isatuximab with pomalidomide and dexamethasone (IsaPD) is still ongoing. The third committee took place in January 2026. At the meeting, the NICE committee discussed the appeal panel’s recommendations and reviewed the revised cost-effectiveness estimates which take into account some of the recent changes in clinical practice – including the switch to generic pomalidomide.

We expect that a final decision will be published in the coming months. The treatment remains available, and in addition to patients already accessing the treatment, it can be offered to patients not currently on IsaPD whilst the appraisal is ongoing

Forward look: SMC

Talquetamab

The SMC appraisal for talquetamab has started. They are appraising its use 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.  We expect to hear more about the timelines for this appraisal soon.