Resource impact statement
No significant resource impact is anticipated
NICE has recommended nivolumab with fluoropyrimidine-based and platinum-based combination chemotherapy as an option for untreated unresectable advanced, recurrent, or metastatic oesophageal squamous cell carcinoma in adults whose tumours express PD-L1 at a level of 1% or more. It is recommended only if:
- pembrolizumab plus chemotherapy is not suitable
- the company provides nivolumab according to the commercial arrangement (see section 2 of the guidance).
This recommendation is not intended to affect treatment with nivolumab that was started in the NHS before this guidance was published. People having treatment outside this recommendation 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 approximately £9,000 per 100,000 population, based on a population for England of 56.3m people).
This is because the population size is small.
Nivolumab has a discount that is commercial in confidence. It is the responsibility of the company to communicate the discounted price to NHS organisations.
This technology is commissioned by NHS England. Providers are NHS hospital trusts.
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