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(s)
Financial and capacity resource impact
The key drivers of resource impact are that:
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Prior to this recommendation, there were no effective maintenance treatments for EGFR mutation-positive locally advanced unresectable non-small-cell lung cancer (NSCLC) following treatment with platinum-based chemoradiotherapy. Treatment with osimertinib will therefore result in additional drug costs.
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Treatment with osimertinib is associated with an increased risk of cardiotoxicity and will require additional cardiac monitoring, with either an electrocardiogram (ECG) or echocardiogram. The frequency of monitoring may be dependent on the person's pre-existing cardiovascular function.
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Treatment with osimertinib can improve outcomes including progression-free survival and may impact subsequent treatment decisions. As people who have osimertinib as maintenance treatment are unlikely to have retreatment with an EGFR tyrosine kinase inhibitor (TKI) after progression, use of osimertinib at a later stage in the pathway is likely to decline.
The company has a commercial arrangement. This makes osimertinib available to the NHS at a discount.
Users can input the confidential price of osimertinib and amend other variables in the resource impact template.
The payment mechanism for the technology is determined by the responsible commissioner and depends on whether the technology is classified as high cost.
Eligible population for osimertinib
Table 1 shows the population who are eligible for osimertinib and the number of people who are expected to have osimertinib in each of the next 3 years, excluding forecast population growth.
| Eligible population and uptake | Number of people eligible for osimertinib | Uptake for osimertinib (%) | Number of people starting treatment each year (if applicable) | Number of people continuing treatment from previous year(s) (if applicable) | Number of people having osimertinib each year |
|---|---|---|---|---|---|
|
Current practice without osimertinib |
0 |
0 |
0 |
0 |
0 |
|
Year 1 |
221 |
45 |
99 |
0 |
99 |
|
Year 2 |
221 |
85 |
187 |
99 |
287 |
|
Year 3 |
221 |
85 |
187 |
287 |
474 |
Table 2 shows the assumptions used to calculate the eligible population:
| Eligibility criteria | Proportion (%) | Eligible population | Source |
|---|---|---|---|
|
Incidence of NSCLC |
– |
38,778 |
|
|
People diagnosed at Stage III |
16.46 |
6,383 |
|
|
NSCLC that is unresectable |
70.97 |
4,530 |
Based on figures reported in the National Lung Cancer Audit State of the-Nation 2024 (see resource impact template for further details) |
|
Advanced NSCLC patients, tested for EGFRm |
92.00 |
4,168 |
Adizie JB et al. (table 2) |
|
Adequate testing sample obtained |
98.00 |
4,084 |
Adizie JB et al. (table 2) |
|
People identified to have EGFRm |
10.00 |
408 |
Adizie JB et al. (table 2) |
|
Proportion of people EGFRm patients with L858m or Exon 19 detection |
90 |
368 |
|
|
People with stage III disease receiving chemoradiation |
60 |
221 |
National Lung Cancer Audit, State of the Nation Report 2024 (page 5) |
|
Eligible population |
– |
221 |
– |
The uptake for osimertinib is based on company and NHS England estimates.
Treatment options for the eligible population
Osimertinib is an oral tablet taken once daily with each pack containing 30 tablets.
The comparator treatment for the eligible population is best supportive care.
For more information about the treatments, such as dose and average treatment duration, see the resource impact template. The mean treatment duration is commercial in confidence. It is assumed in the template that the treatment duration continues over the 3‑year timespan of the template.
Key information
| Time from publication to routine commissioning funding |
90 days |
|---|---|
| Programme budgeting category |
2D Cancers & Tumours – Lung |
| Commissioner(s) |
NHS England |
| Provider(s) |
NHS hospital trusts |
| Pathway position |
After platinum-based radiochemotherapy. |
About this resource impact summary report
This resource impact summary report accompanies the NICE technology appraisal guidance on osimertinib for maintenance treatment of EGFR mutation-positive locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiotherapy and should be read with it.
ISBN: 978-1-4731-9526-4
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