Resource impact statement
NICE has recommended secukinumab as an option for treating active moderate to severe hidradenitis suppurativa (acne inversa) in adults when it has not responded well enough to conventional systemic treatment, only if:
- adalimumab is not suitable, did not work or has stopped working
- the company provides secukinumab according to the commercial arrangement.
Assess response to secukinumab after the first 16 weeks of treatment, and only continue if there is clear evidence of a response, defined as:
- a reduction of 25% or more in the total abscess and inflammatory nodule count, and
- no increase in abscesses and draining fistulas.
This recommendation is not intended to affect treatment with secukinumab 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 expect the resource impact of implementing the recommendations in England will be less than £5 million per year (or approximately £8,800 per 100,000 population, based on a population for England of 56.6 million people).
This is because the population size is small, clinical experts estimate the eligible population is between 400 and 800 people. There may be an additional 4 dermatology outpatient attendances in the first year for people whose condition responds and for subsequent years it is anticipated there will be 2 per year. For people whose condition does not respond at 16 weeks there is expected to be 2 additional outpatent appointments.
Current treatment for people with moderate to severe hidradenitis suppurativa when conventional systemic treatment has not worked well enough is adalimumab. For this evaluation, the company asked for secukinumab to be considered only for people who cannot have adalimumab or whose condition has not responded or has stopped responding to it. This does not include everyone who secukinumab is licensed for.
Evidence shows that compared to best supportive care secukinumab improves symptoms of moderate to severe hidradenitis suppurativa.
The company has a commercial arrangement. This makes secukinumab 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.
This technology is commissioned by NHS England. Providers are NHS hospital trusts.
The payment mechanism for the technology is determined by the responsible commissioner and depends on the technology being classified as high cost.
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