Resource impact statement

No significant resource impact is anticipated

NICE has recommended atezolizumab as an option for untreated locally advanced or metastatic urothelial cancer in adults whose tumours express PD‑L1 at a level of 5% or more and when cisplatin-containing chemotherapy is unsuitable. This is only if the company provides atezolizumab according to the commercial arrangement.

The guidance constitutes a further review of additional evidence collected as part of the Cancer Drugs Fund managed access agreement for atezolizumab for untreated PD‑L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable (NICE technology appraisal guidance 492).

We do not expect this guidance to have a significant impact on resources; that is, the resource impact of implementing the recommendations in England will be less than £5 million per year (or approximately £9,000 per 100,000 population, based on a population for England of 56.3 million people).

This is because the population size is small with around 130 people per year eligible for treatment. It is not expected that the number of people using atezolizumab will change as a result of moving from the Cancer Drugs Fund into routine commissioning.

The company has a commercial arrangement (simple discount patient access scheme). This makes atezolizumab available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.

Atezolizumab is commissioned by NHS England. Providers are NHS hospital trusts.

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