Brentuximab vedotin in combination for untreated stage 3 or 4 CD30-positive Hodgkin lymphoma

Recommendation

NICE has recommended brentuximab vedotin plus doxorubicin, dacarbazine and vinblastine within its marketing authorisation, as an option for untreated stage 3 or 4 CD30‑positive Hodgkin lymphoma in adults.

Eligible population for brentuximab vedotin

Table 1 shows the population who are eligible for brentuximab vedotin in combination and the number of people who are expected to have brentuximab vedotin in combination in each of the next 5 years, including forecast population growth.

The following assumptions have been used to calculate the eligible population:

The uptake for brentuximab vedotin is based on NHS England clinical expert opinion.

Treatment options for the eligible population

The comparator treatment for the eligible population is ABVD.

Brentuximab combination (A+AVD) and ABVD are both administered by IV infusion and 90% of people having ABVD are estimated to have a PET scan. People with a negative scan have another 4 cycles of AVD (without bleomycin) while people with a positive scan either have a 4 further cycles of ABVD, or their treatment is escalated to BEACOPDac. The remaining 10% do not have a PET scan and have up to 6 cycles of ABVD.

Evidence from a clinical trial shows that A+AVD could increase how long people have before their cancer gets worse and how long they live compared with ABVD.

The resource impact template uses subsequent therapy rates that may be greater than 100% because of an assumption that multiple lines of subsequent therapy take place.

For more information about the treatments, such as dose, subsequent treatments and average treatment duration, see the resource impact template.

Financial resource impact (cash items)

The company has a commercial arrangement. This makes brentuximab vedotin available to the NHS with a discount.

Users can input the confidential price of brentuximab vedotin and amend other variables in the resource impact template.

The payment mechanism for the technology is determined by the responsible commissioner and depends on the technology being classified as high cost.

For further analysis or to calculate the financial impact of cash items, see the resource impact template.

Capacity impact

Adopting brentuximab combination may lead to a reduction in the number of chemotherapy appointments, PET scans and subsequent treatments. The estimated capacity implications can be calculated using the resource impact template.

For further analysis or to calculate the financial capacity impact from a commissioner (national) and provider (local) perspective, see the resource impact template.

Key information

About this resource impact summary report

This resource impact summary report accompanies the NICE technology appraisal guidance on brentuximab vedotin in combination for untreated stage 3 or 4 CD30-positive Hodgkin lymphoma and should be read with it. See terms and conditions on the NICE website.

ISBN: 978-1-4731-7012-4