Resource impact statement

No significant resource impact is anticipated

NICE has recommended diroximel fumarate as an option for treating active relapsing–remitting multiple sclerosis (normally defined as 2 clinically significant relapses in the previous 2 years) in adults, only if they do not have highly active or rapidly evolving severe relapsing–remitting multiple sclerosis and the company provides diroximel fumarate according to the commercial arrangement.

If patients and their clinicians consider diroximel fumarate to be one of a range of suitable treatments (including dimethyl fumarate), choose the least expensive treatment, taking into account administration costs, dosage, price per dose and commercial arrangements.

These recommendations are not intended to affect treatment with diroximel fumarate that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

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 £9,000 per 100,000 population).

This is because the technology is a further treatment option and the overall cost of treatment will be similar.

The use of diroximel fumarate is not expected to result in additional service requirements. It is a further oral treatment option which can increase convenience for people who use it and may save costs. The use of diroximel fumarate may also free up healthcare professional capacity compared to treatments administered by intravenous infusions in hospital. However, any savings as a result are not expected to be significant at a national level.

Diroximel fumarate has a discount that is commercial in confidence. It is the company’s responsibility to let relevant NHS organisations know details of the discount.

This technology is commissioned by NHS England. Providers are NHS hospital trusts.

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