Resource impact summary report

Resource impact summary report

This summary report is based on the NICE assumptions used in the resource impact template. Users can amend the 'Inputs and eligible population' and 'Unit costs' worksheets in the template to reflect local data and assumptions.

Recommendation

Durvalumab can be used, within its marketing authorisation, as an option to treat limited-stage small-cell lung cancer that has not progressed after platinum-based chemoradiotherapy in adults. Durvalumab can only be used if the company provides it according to the commercial arrangement.

Eligible population for durvalumab

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

Table 1 Population expected to be eligible for and have durvalumab in England
Eligible population and uptake People eligible for durvalumab  Uptake for durvalumab (%)  People having durvalumab each year 

Current practice without durvalumab

520

0

0

Year 1

525

45

236

Year 2

530

90

477

Year 3

534

90

481

Year 4

539

90

485

Year 5

544

90

489

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

  • Based on Cancer Registrations Statistics (England 2022), it is estimated that around 3,200 adults are diagnosed with small-cell lung cancer (SCLC) each year.

  • 31.47% are assumed to have limited-stage SCLC as per a study by Khakwani et al. (2014).

  • The National Lung Cancer Audit's State of the Nation Report 2024 shows 55.5% of people with SCLC have a performance status of 0-1. It is assumed this group will receive chemoradiotherapy. This assumption can be adjusted in the template.

  • 92% of people who receive chemoradiotherapy will not experience progression of their disease as per the company submission and are eligible for treatment with durvalumab.

  • Uptake for durvalumab is based on clinical expert opinion.

Treatment options for the eligible population

Durvalumab is used in addition to active monitoring when the cancer has not progressed. It is administered intravenously.

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

Financial resource impact (cash items)

The key drivers of financial resource impact are:

  • the drug costs and additional administrations, oncologist appointments required while on durvalumab rather than active monitoring

  • a decreased need for subsequent treatment costs along with any savings for associated administrations, appointments and scans.

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

Users can input the confidential price of durvalumab 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

Table 2 shows the impact on capacity activity in each of the next 5 years.

Table 2 Capacity impact (activity) in England
Capacity impact Number of administration appointments (not accounting for subsequent treatments) Number of CT scans (chest and abdomen scans) Number of follow-up attendances

Current practice (without durvalumab)

0

6,211

9,326

Year 1

3,047

7,678

10,714

Year 2

6,148

7,832

10,787

Year 3

6,202

8,139

11,120

Year 4

6,257

8,210

11,218

Year 5

6,312

8,282

11,317

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

Table 3 Key information

Time from publication to routine commissioning funding

90 days

Programme budgeting category

2D Cancers & Tumours – Lung

Commissioner

NHS England

Provider

NHS hospital trusts

Pathway position

Post surgery and after platinum-based radiochemotherapy

About this resource impact summary report

This resource impact summary report accompanies the NICE technology appraisal guidance on Durvalumab for treating limited-stage small-cell lung cancer after platinum-based chemoradiotherapy and should be read with it.

ISBN: 978-1-4731-7233-3

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