Resource impact statement
NICE has recommended targeted-release budesonide as an option for treating primary immunoglobulin A nephropathy (IgAN) when there is a risk of rapid disease progression in adults with a urine protein-to-creatinine ratio of 1.5 g/g or more. Targeted-release budesonide is recommended only if:
- it is an add-on to optimised standard care including the highest tolerated licensed dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), unless these are contraindicated and
- the company provides it according to the commercial arrangement.
This recommendation is not intended to affect treatment with targeted-release budesonide 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).
It is estimated that around 1,500 people will be eligible for treatment. This considers the relevant population where there is a risk of rapid disease progression. Both standard care treatments and budesonide are oral treatments, therefore no overall impact on NHS capacity is anticipated.
The company has a commercial arrangement (simple discount patient access scheme). This makes targeted-release budesonide 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 for adults with primary IgAN and is commissioned by integrated care boards. 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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