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 'Population and treatments' and 'Unit costs' worksheets in the template to reflect local data and assumptions.
Guidance recommendation
See NICE's recommendation on obinutuzumab with mycophenolate mofetil for treating lupus nephritis.
Financial and capacity resource impact
The key drivers of resource impact are that:
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Obinutuzumab is an intravenous treatment. It is assumed that it will displace the use of rituximab, which is also administered intravenously. Obinutuzumab however requires 2 more administrations than rituximab in the initial year of treatment. If any oral treatments are displaced there will be a greater capacity impact.
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The infusion time for obinutuzumab is longer than rituximab.
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Effective treatment options for people with lupus nephritis would result in them being less likely to require dialysis or renal transplant.
The company has a commercial arrangement. This makes obinutuzumab available to the NHS at a discount.
Users can input the confidential price of obinutuzumab and amend other variables in the resource impact template. It should be noted that the adverse events for obinutuzumab are commercial in confidence and will need to be added locally for them to be reflected in the costings.
The payment mechanism for the technology is determined by the responsible commissioner and depends on whether the technology is classified as high cost.
For further analysis, see the resource impact template.
Eligible population for obinutuzumab
Table 1 shows the population who are eligible for obinutuzumab and the number of people who are expected to have obinutuzumab in each of the next 3 years, excluding forecast population growth.
| Eligible population and uptake | Number of people eligible for obinutuzumab | Uptake for obinutuzumab (%) | Number of people starting treatment each year | Number of people continuing treatment from previous year(s) | Number of people having obinutuzumab each year |
|---|---|---|---|---|---|
|
Current practice without obinutuzumab |
11,711 |
0 |
0 |
0 |
0 |
|
Year 1 |
11,711 |
10 |
1,171 |
0 |
1,171 |
|
Year 2 |
11,711 |
30 |
2,342 |
1,171 |
3,513 |
|
Year 3 |
11,711 |
40 |
1,171 |
3,513 |
4,684 |
The following assumptions have been used to calculate the eligible population:
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systemic lupus erythematosus (SLE) is prevalent in around 107 per 100,000 adults
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the British Society for Rheumatology guidelines state that about one-third of people with SLE in the UK develop lupus nephritis
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70% of people with lupus nephritis have stage 3, 4 or 5 disease.
The market share for obinutuzumab is based on clinical expert opinion.
Treatment options for the eligible population
First treatment for lupus nephritis is usually mycophenolate mofetil (MMF) with corticosteroids (referred to as MMF alone from now). If MMF alone is insufficient to induce remission, another treatment is added. The comparator treatments for the eligible population are MMF alone or in combination with rituximab, belimumab or voclosporin. Rituximab is the main comparator, and the resource impact template assumes that obinutuzumab will displace use of rituximab.
Obinutuzumab and rituximab are intravenous treatments. Belimumab can be administered intravenously or via subcutaneous injection. MMF and voclosporin are oral treatments.
For more information about the treatments, such as dose and average treatment duration, see the resource impact template.
Key information
| Time from publication to routine commissioning funding |
90 days |
|---|---|
| Programme budgeting category |
15B, Problems of the musculoskeletal system |
| Commissioner(s) |
NHS England |
| Provider(s) |
NHS hospital trusts |
| Pathway position |
Treatment of adult patients with active Class III or IV, with or without concomitant Class V, lupus nephritis |
About this resource impact summary report
This resource impact summary report accompanies the NICE technology appraisal guidance on obinutuzumab with mycophenolate mofetil for treating lupus nephritis and should be read with it.
ISBN: 978-1-4731-9284-3
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