Maribavir for treating refractory cytomegalovirus infection after transplant

1.1 Maribavir is recommended, within its marketing authorisation, as an option for treating cytomegalovirus (CMV) infection that is refractory to treatment including cidofovir, foscarnet, ganciclovir or valganciclovir in adults who have had a haematopoietic stem cell transplant or solid organ transplant. It is recommended only if the company provides it according to the commercial arrangement.

Why the committee made these recommendations

After a transplant, for CMV infection that does not respond well enough to treatment, usual treatment is cidofovir, foscarnet, ganciclovir or valganciclovir, or combinations of these.

Clinical evidence suggests that maribavir gets rid of CMV infection better than usual treatment, but this is uncertain because of the way the trial was done.

The most likely cost-effectiveness estimates are also uncertain. But they are towards the lower end of the range that NICE considers an acceptable use of NHS resources, and current treatment options are limited. So maribavir is recommended.