Resource impact statement
NICE has recommended belumosudil within its marketing authorisation, for treating chronic graft-versus-host disease (GVHD) in people 12 years and over after 2 or more systemic treatments.
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, with around 65 people eligible each year.
Currently, extracorporeal photopheresis (ECP) is the most frequently used treatment with a small number of people receiving imatinib, mycophenolate mofetil, pentostatin, rituximab, pulsed corticosteroids or sirolimus. ECP requires regular hospital appointments for intravenous infusions. This could involve inserting and removing central lines where peripheral venous access is not possible, and the need for blood transfusions and anticoagulation therapy.
Clinical experts in haematology highlighted that although ECP is a good option for people with chronic GVHD, people would favour an oral option over having to travel because of the increased risk of catching infections on public transport and being admitted to hospital as a result. The committee noted the high unmet need for a new treatment option after 2 systemic therapies. It concluded that current treatment options are limited, with rituximab and pentostatin administered by intravenous infusion, therefore an oral treatment would be beneficial.
The company has a commercial arrangement, (simple discount patient access scheme). This makes belumosudil 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 bein
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