Resource impact summary report
This summary report is based on the NICE assumptions used in the resource impact template. Users can amend the 'Inputs and eligible population' and 'Unit costs' worksheets in the template to reflect local data and assumptions.
Recommendation
NICE has recommended ublituximab, as an option for treating relapsing forms of multiple sclerosis, defined as active by clinical or imaging features in adults, only if:
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the multiple sclerosis is relapsing–remitting, and
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the company provides it according to the commercial arrangement.
Use the least expensive option of the available treatments (including ublituximab, ocrelizumab and ofatumumab). Take account of administration costs, dosages, price per dose and commercial arrangements. If the least expensive option is unsuitable, people with the condition and their healthcare professional should discuss the advantages and disadvantages of other treatments.
Eligible population for ublituximab
The following assumptions have been used to calculate the eligible population:
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The MS Trust webpage on how common is multiple sclerosis states there are around 123,000 people living with multiple sclerosis in England.
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The MS Society webpage on relapsing remitting MS (RRMS) states 85% of people with multiple sclerosis are diagnosed with RRMS. Twenty years after diagnosis, around 50% of these people will have progressed to secondary progressive multiple sclerosis (SPMS). Assuming about half of all people in the prevalent population are 20 years post diagnosis, around 85% x 50% x 50% will have progressed to SPMS. This leaves 85% x 75% (63.75%) with RRMS at any one time. This has been estimated by a Professor of Clinical Neurology.
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The MS Society My MS My Needs 2022 report states 56% of people with RRMS are treated with a disease modifying therapy (DMT).
Treatment options for the eligible population
Treatment options for active RRMS include immunomodulatory treatments such as teriflunomide and anti-CD20 monoclonal antibodies, such as ocrelizumab and ofatumumab. Ublituximab is another treatment option that works in a similar way to ocrelizumab and ofatumumab and would be offered to the same population. For more information about all treatments for multiple sclerosis, such as dose and average treatment duration, see the resource impact template.
The comparative annual costs for each treatment can be seen at the top of the unit costs tab once all of the prices for each treatment option have been input to the inputs and eligible population tab.
Financial resource impact (cash items)
The company has a commercial arrangement. This makes ublituximab available to the NHS with a discount.
Users can input the confidential price of ublituximab 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.
For further analysis or to calculate the financial impact of cash items, see the resource impact template.
Capacity impact
Ublituximab is delivered entirely as intravenous (IV) infusions in multiple sclerosis clinics, while ocrelizumab can be delivered as IV infusions or subcutaneous (SC) injections in multiple sclerosis clinics or at home. Ofatumumab requires SC injections that are started in multiple sclerosis clinics but then intended to be administered at home. There will be a capacity impact if there is a market share change from ofatumumab or ocrelizumab (SC) to ublituximab (IV).
The template includes all comparator options for treating RRMS in adults with active disease defined by clinical or imaging features.
For further analysis or to calculate the financial capacity impact from a commissioner (national) and provider (local) perspective, see the resource impact template.
Key information
| Time from publication to routine commissioning funding |
30 days |
|---|---|
| Programme budgeting category |
07X Neurological, Neurological |
| Commissioner(s) |
NHS England |
| Provider(s) |
Secondary care - acute |
| Pathway position |
Relapsing multiple sclerosis |
About this resource impact summary report
This resource impact summary report accompanies the NICE technology appraisal guidance on ublituximab for treating relapsing multiple sclerosis and should be read with it. See terms and conditions on the NICE website.
ISBN: 978-1-4731-6715-5