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 recommendations
Financial and capacity resource impact
The company has a commercial arrangement (commercial access agreement). This makes daratumumab available to the NHS with a discount. The size of the discount is commercial in confidence.
Users can input the confidential price of daratumumab 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.
Clinical trial evidence shows that daratumumab plus bortezomib, lenalidomide and dexamethasone increases how long people have before their condition gets worse and how long they live compared with bortezomib, lenalidomide and dexamethasone.
Table 1 shows the impact on capacity activity in each of the next 3 years.
| Year | Number of administrations |
|---|---|
|
Current practice |
152,889 |
|
Year 1 |
171,960 |
|
Year 2 |
183,782 |
|
Year 3 |
191,032 |
There will be a capacity increase due to an increase in administrations. The increase in administrations is due to the estimated increase in uptake for both daratumumab with bortezomib, lenalidomide and dexamethasone and isatuximab with bortezomib, lenalidomide, and dexamethasone.
For further analysis, or to calculate the financial and capacity impact from a commissioner and provider perspective, see the resource impact template.
Eligible population for daratumumab with bortezomib, lenalidomide and dexamethasone
For this evaluation, the company asked for daratumumab with bortezomib, lenalidomide and dexamethasone to be considered only for untreated multiple myeloma in adults when an autologous stem cell transplant (ASCT) is unsuitable. This does not include everyone that it is licensed for.
Table 2 shows the population who are eligible for daratumumab with bortezomib, lenalidomide and dexamethasone and the number of people who are expected to have the treatment, excluding forecast population growth.
| Eligible population and uptake | Number of people eligible | Uptake for (%) | Number of people starting treatment each year | Number of people continuing treatment from previous years | Number of people having treatment each year |
|---|---|---|---|---|---|
|
Current practice |
3,152 |
0 |
0 |
0 |
0 |
|
Year 1 |
3,152 |
20 |
630 |
0 |
630 |
|
Year 2 |
3,152 |
30 |
946 |
630 |
1,576 |
|
Year 3 |
3,152 |
40 |
1,261 |
1,576 |
2,837 |
The following assumptions have been used to calculate the eligible population:
-
The number of people who are diagnosed with multiple myeloma is around 5,900 each year in England (Cancer Registration Statistics, England 2023).
-
The company submission in line with assumptions from TA1098 estimates 67% of people with multiple myeloma are ineligible for ASCT.
-
Clinical expert opinion is that 80% of people with multiple myeloma who are ineligible for ASCT will have treatment.
The future uptake for daratumumab with bortezomib, lenalidomide and dexamethasone is based on clinical expert opinion.
Treatment options for the eligible population
Usual treatment for adults with untreated multiple myeloma when an ASCT is unsuitable includes:
-
daratumumab plus lenalidomide and dexamethasone (TA917)
-
isatuximab plus bortezomib, lenalidomide and dexamethasone (TA1098).
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 |
02I cancer, Haematological |
| Commissioner |
NHS England |
| Provider |
NHS Hospital trusts |
| Pathway position |
Untreated multiple myeloma when a stem cell transplant is unsuitable |
About this resource impact summary report
This resource impact summary report accompanies the NICE technology appraisal guidance on daratumumab with bortezomib, lenalidomide and dexamethasone for untreated multiple myeloma when a stem cell transplant is unsuitable and should be read with it.
ISBN: 978-1-4731-9575-2
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