Decision to widen access to brentuximab vedotin for the treatment of systemic anaplastic large cell lymphoma

12 March 2026

Medicines Decision

What we’re doing

We’re pleased to announce that the access criteria for brentuximab vedotin (brand name Adcetris) will be widened to include first line treatment for systemic anaplastic large cell lymphoma (sALCL) from 1 April 2026.

What does this mean for people?

People with systemic anaplastic large‑cell lymphoma (sALCL) in New Zealand currently face poor outcomes and limited treatment options. At present, brentuximab vedotin is only funded for those whose disease has relapsed or not responded after first‑line treatment, leaving an unmet health need for individuals newly diagnosed with sALCL.

Expanding funding to include people with previously untreated sALCL will allow earlier access to a treatment that has demonstrated clear clinical benefits. Evidence shows that first-line use of brentuximab vedotin improves progression‑free survival compared with current therapies, and the Cancer Treatments Advisory Committee (CTAC) considers it likely to offer better quality of life than existing options.

By widening access, around 12 people in the first year, and approximately 60 people over the first five years, will be able to receive a treatment that may improve their outcomes from the outset. People who are receiving brentuximab vedotin within private clinical facilities who met the eligibility criteria when they started treatment will be funded to continue doing so for up to 12 months without needing to transfer to a public hospital.

Any changes to the original proposal?

This decision was subject to a consultation letter(external link) dated 05 February 2026. We received feedback from individuals and their whānau, clinicians, advocacy groups, suppliers, consumers, and health sector stakeholders.

We’re grateful to those who took the time to respond to our consultation. This is an important part of our decision-making process. It gives us the opportunity to listen to the voices of the community and acknowledge and respond to feedback.

The feedback received was very supportive of our proposal. In total we received 114 responses, of which 112 were supportive of the proposal, and two were supportive with considerations or caveats.

Considerations were raised by respondents regarding the specific wording of the special authority criteria, including:

Removing the requirement for ‘curative intent’ of treatment
Removing specific designation of steroid or anthracycline to be used in combination with brentuximab vedotin

Pharmac has modified the wording of the proposed access criteria in response to the above consultation feedback. These changes will not impact people who are eligible for treatment, but they aim to give more flexibility to prescribers in the way that they use brentuximab vedotin to treat blood cancer.

Who we think will be most interested

People with sALCL, their whānau, and caregivers
Haematologists, oncologists, and health professionals involved in the care of people with sALCL
Groups who support and advocate for the people with sALCL
Health New Zealand | Te Whatu Ora
Pharmaceutical suppliers and wholesalers

Detail about this decision

The following changes will occur in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 April 2026 (new and affected criteria shown only, additions in bold, deletions in strikethrough).

Section B changes

Special Authority for Subsidy

Initial application - (CD30 positive systemic anaplastic large-cell lymphoma) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria:

Either:

Patient is currently on treatment with brentuximab vedotin and met all the following criteria prior to commencing treatment; or
All of the following:
1. Patient has CD30 positive systemic anaplastic large-cell lymphoma; and
2. Patient must have histological confirmation of CD30 expression; and
3. Patient must not have received prior treatment with curative intent chemotherapy for this condition; and
4. Treatment must be in combination with cyclophosphamide, anthracycline, and steroids for a maximum of 8 cycles; and
5. Brentuximab vedotin is to be administered at doses no greater than 1.8 mg/kg every 3 weeks.

Initial application – (relapsed/refractory anaplastic large cell lymphoma) from any relevant practitioner. Approvals valid for 6 9 months for applications meeting the following criteria:

All of the following:

Patient has relapsed/refractory CD30-positive systemic anaplastic large cell lymphoma; and
Patient has an ECOG performance status of 0-1; and
Patient has not previously received brentuximab vedotin; and
Response to brentuximab vedotin treatment is to be reviewed after a maximum of 6 treatment cycles; and
Brentuximab vedotin to be administered at doses no greater than 1.8 mg/kg every 3 weeks.

Renewal – (relapsed/refractory anaplastic large cell lymphoma) from any relevant practitioner. Approvals valid for 9 months for applications meeting the following criteria:

All of the following:

Patient has experienced a partial or complete response to brentuximab vedotin after 6 treatment cycles; and
Treatment remains clinically appropriate and the patient is benefitting from treatment and treatment is tolerable; and
Patient is to receive a maximum of 16 total cycles of brentuximab vedotin treatment.

Similar eligibility criteria would apply in Part II of Section H of the Pharmaceutical Schedule.

Our response to what you told us

We’re grateful for the time people took to respond to this consultation. A summary of the main themes raised in feedback, our responses to the feedback received, and changes we have made after listening to you are available on our notification webpage.

Themes by Role	Pharmac Response
Whānau / family: Equity and access / affordability: Many stressed that public funding would prevent financial hardship and widen access. Quality of life and family impact: Frequent references to young patients with small children and the importance of preserving time with whānau. Cost and value: Several responses noted that earlier, funded access would reduce downstream costs to the system. Urgency / fast‑tracking: Repeated calls to approve and make treatment available “as soon as possible.” International alignment: A few responses pointed to funding in Australia/UK and asked NZ to align.	We heard strong support for widening access and many personal stories about the financial strain caused by sALCL treatment. We recognise the importance of equitable, publicly funded access and remain committed to reducing barriers where we can. Our proposal is intended to improve health outcomes for people with sALCL, and to relieve some of the burden placed on their family and whānau. We know quality of life and time together matters, and we’re working to act with urgency where we can. We are pleased that widening access to brentuximab vedotin in the first line would provide another option for New Zealanders living with sALCL.
Prescribers and pharmacists: Clinical evidence: Support anchored in ECHELON‑2 and other data showing improved outcomes with first‑line brentuximab vedotin withCHP therapy. Retreatment / second‑line clarity: One prescriber requested clarity on retreatment and simplification of special authority criteria and suggested that retreatment should still be permitted. Suggestion to establish an easier pathway to update Special Authority criteria promptly when practice‑changing evidence is published.	We would like to thank prescribers for their clinical guidance and practical feedback. We’ve considered the ECHELON‑2 evidence through our clinical advice processes and are progressing a proposal aimed at improving outcomes for people with sALCL. In response to feedback from prescribers, we’re simplifying Special Authority criteria, removing the requirement to specify particular steroids or anthracycline, and removing wording around curative intent. This aims to better reflect real‑world care without changing who is eligible in practice. Based on expert advice, retreatment with brentuximab vedotin will not be funded at this time, as our advisors have told us there isn’t sufficient evidence to support funding repeated treatment at later lines. If new evidence becomes available, we can reconsider this. We appreciate the feedback highlighting the need for a pathway to rapidly update existing funding criteria when new evidence becomes available. Anyone is welcome to contact us at any time if they become aware of new evidence that may indicate our criteria should be updated. You can email a request to enquiries@pharmac.govt.nz. We recognise that some requests may not require a full formal funding application, and we can work with you to determine the most appropriate next steps within our funding process to consider any potential changes. We also understand there is a desire to simplify how requests are made, and this is something we can take into account as we explore future improvements to our advice and assessment processes.
Person who uses / may use: Urgency and first‑line need: Newly diagnosed individuals described having started CHOP therapy and wanting brentuximab vedotin alongside chemotherapy as soon as possible to maximise benefit. Eligibility clarity: One submitter queried eligibility where the treating team’s aim is remission (not “curative intent”), underscoring potential Special Authority wording friction with real‑world practice. Quality of life: Emphasis on preserving health, livelihood, and family stability.	We recognise the urgency and what treatment means for people’s daily lives. This proposal is intended to widen access so people can receive funded treatment for sALCL at an earlier stage. People questioned our use of the phrase “curative intent” in the Special Authority criteria, stating that this doesn’t necessarily reflect real‑world treatment goals. We’re updating the wording on the advice of CTAC feedback, so criteria are clearer and fit how care is actually delivered.
Group representing people with health conditions: We received strong endorsement of widening access to first‑line brentuximab vedotin to improve outcomes in a rare, aggressive T‑cell lymphoma with historically limited options. Alignment with contemporary international care and the importance of a system ready to adopt emerging targeted therapies in a timely, equitable manner. Emphasis on equity, timeliness, and hope for a small but vulnerable population; encouragement for continued focus on T‑cell lymphomas.	Pharmac would like to thank groups who support people with sALCL who took the time to provide feedback. We’re pleased that widening access to brentuximab vedotin in the first line would provide another option for New Zealanders with sALCL.

Themes by Role

Pharmac Response

Whānau / family:

Equity and access / affordability: Many stressed that public funding would prevent financial hardship and widen access.

Quality of life and family impact: Frequent references to young patients with small children and the importance of preserving time with whānau.

Cost and value: Several responses noted that earlier, funded access would reduce downstream costs to the system.

Urgency / fast‑tracking: Repeated calls to approve and make treatment available “as soon as possible.”

International alignment: A few responses pointed to funding in Australia/UK and asked NZ to align.

We heard strong support for widening access and many personal stories about the financial strain caused by sALCL treatment. We recognise the importance of equitable, publicly funded access and remain committed to reducing barriers where we can.

Our proposal is intended to improve health outcomes for people with sALCL, and to relieve some of the burden placed on their family and whānau.

We know quality of life and time together matters, and we’re working to act with urgency where we can.

We are pleased that widening access to brentuximab vedotin in the first line would provide another option for New Zealanders living with sALCL.

Prescribers and pharmacists:

Clinical evidence: Support anchored in ECHELON‑2 and other data showing improved outcomes with first‑line brentuximab vedotin withCHP therapy.

Retreatment / second‑line clarity: One prescriber requested clarity on retreatment and simplification of special authority criteria and suggested that retreatment should still be permitted.

Suggestion to establish an easier pathway to update Special Authority criteria promptly when practice‑changing evidence is published.

We would like to thank prescribers for their clinical guidance and practical feedback. We’ve considered the ECHELON‑2 evidence through our clinical advice processes and are progressing a proposal aimed at improving outcomes for people with sALCL.

In response to feedback from prescribers, we’re simplifying Special Authority criteria, removing the requirement to specify particular steroids or anthracycline, and removing wording around curative intent. This aims to better reflect real‑world care without changing who is eligible in practice.

Based on expert advice, retreatment with brentuximab vedotin will not be funded at this time, as our advisors have told us there isn’t sufficient evidence to support funding repeated treatment at later lines. If new evidence becomes available, we can reconsider this.

We appreciate the feedback highlighting the need for a pathway to rapidly update existing funding criteria when new evidence becomes available.

Anyone is welcome to contact us at any time if they become aware of new evidence that may indicate our criteria should be updated. You can email a request to enquiries@pharmac.govt.nz. We recognise that some requests may not require a full formal funding application, and we can work with you to determine the most appropriate next steps within our funding process to consider any potential changes. We also understand there is a desire to simplify how requests are made, and this is something we can take into account as we explore future improvements to our advice and assessment processes.

Person who uses / may use:

Urgency and first‑line need: Newly diagnosed individuals described having started CHOP therapy and wanting brentuximab vedotin alongside chemotherapy as soon as possible to maximise benefit.

Eligibility clarity: One submitter queried eligibility where the treating team’s aim is remission (not “curative intent”), underscoring potential Special Authority wording friction with real‑world practice.

Quality of life: Emphasis on preserving health, livelihood, and family stability.

We recognise the urgency and what treatment means for people’s daily lives. This proposal is intended to widen access so people can receive funded treatment for sALCL at an earlier stage.

People questioned our use of the phrase “curative intent” in the Special Authority criteria, stating that this doesn’t necessarily reflect real‑world treatment goals. We’re updating the wording on the advice of CTAC feedback, so criteria are clearer and fit how care is actually delivered.

Group representing people with health conditions:

We received strong endorsement of widening access to first‑line brentuximab vedotin to improve outcomes in a rare, aggressive T‑cell lymphoma with historically limited options.

Alignment with contemporary international care and the importance of a system ready to adopt emerging targeted therapies in a timely, equitable manner.

Emphasis on equity, timeliness, and hope for a small but vulnerable population; encouragement for continued focus on T‑cell lymphomas.

Pharmac would like to thank groups who support people with sALCL who took the time to provide feedback.

We’re pleased that widening access to brentuximab vedotin in the first line would provide another option for New Zealanders with sALCL.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.