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 'Inputs and eligible population' and 'Unit costs' worksheets in the template to reflect local data and assumptions.
Recommendation
NICE has recommended durvalumab for neoadjuvant treatment with platinum-based chemotherapy, then continued alone as adjuvant treatment as an option for treating non-small-cell lung cancer (NSCLC) in adults whose cancer:
-
is resectable (tumours 4 cm or over, or node positive) and
-
has no epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements.
Durvalumab is only recommended if the company provides it according to the commercial arrangement.
Eligible population for durvalumab
Table 1 shows the population who are eligible for durvalumab and the number of people who are expected to have durvalumab in each of the next 5 years.
| Eligible population and uptake | Current practice | 2024 to 2025 | 2025 to 2026 | 2026 to 2027 | 2027 to 2028 | 2028 to 2029 |
|---|---|---|---|---|---|---|
|
People eligible for durvalumab |
2,000 |
2,020 |
2,040 |
2,060 |
2,070 |
2,090 |
|
Uptake for durvalumab (%) |
0 |
15 |
30 |
33 |
33 |
33 |
|
People starting treatment each year in neoadjuvant setting |
0 |
300 |
610 |
685 |
690 |
700 |
|
People who have adjuvant treatment after neoadjuvant treatment (%) |
66 |
66 |
66 |
66 |
66 |
66 |
|
People continuing treatment in adjuvant setting |
0 |
200 |
400 |
450 |
460 |
460 |
The uptake for durvalumab is based on the assumption that the market share of the 3 treatment options will equalize over time by year 5 to 33% each.
Treatment options for the eligible population
The comparator treatments for the eligible population are pembrolizumab with chemotherapy and nivolumab with chemotherapy in the neoadjuvant setting. It is assumed that a proportion of people who had durvalumab with chemotherapy and pembrolizumab with chemotherapy will go on to have the respective treatment option as a monotherapy in the adjuvant setting. Adjuvant nivolumab is not a recommended treatment option and so people who have neoadjuvant nivolumab with chemotherapy have monitoring only in the adjuvant setting.
All 3 options are given intravenously, although durvalumab is given as a 60‑minute infusion rather than a 30‑minute transfusion for the other treatment options.
For more information about the treatments, such as dose and average treatment duration, see the resource impact template.
Financial resource impact (cash items)
The company has a commercial arrangement. This makes durvalumab available to the NHS with a discount.
Users can input the confidential price of durvalumab 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
Table 2 shows the impact on capacity activity in each of the next 5 years.
| Capacity impact | Current practice | 2025 to 2026 | 2026 to 2027 | 2027 to 2028 | 2028 to 2029 | 2029 to 2030 |
|---|---|---|---|---|---|---|
|
Number of intravenous administrations |
8,800 |
14,000 |
19,000 |
20,000 |
20,200 |
20,400 |
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
Table 3 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 |
Neoadjuvant and adjuvant therapy |
About this resource impact summary report
This resource impact summary report accompanies the NICE guidance on durvalumab with chemotherapy before surgery (neoadjuvant) then alone after surgery (adjuvant) for treating resectable non-small-cell lung cancer and should be read with it. See terms and conditions on the NICE website.
ISBN: 978-1-4731-6790-2
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