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 pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy as an option for untreated locally advanced unresectable or metastatic HER2-negative gastric or gastro-oesophageal junction adenocarcinoma in adults whose tumours express PD‑L1 with a combined positive score (CPS) of 1 or more. Pembrolizumab is only recommended if the company provides it according to the commercial arrangement.
Eligible population for pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy
Table 1 shows the population who are eligible for pembrolizumab and the number of people who are expected to have pembrolizumab in each of the next 5 years. These figures include the impact of the predicted population growth.
| Eligible population and uptake | Current practice | 2024 to 25 | 2025 to 26 | 2026 to 27 | 2027 to 28 | 2028 to 29 |
|---|---|---|---|---|---|---|
|
People eligible for pembrolizumab |
1,170 |
1,180 |
1,190 |
1,210 |
1,220 |
1,230 |
|
People having pembrolizumab + chemotherapy each year |
120 |
380 |
570 |
640 |
650 |
650 |
|
Uptake for pembrolizumab + CAPOX (%) |
7 |
22 |
34 |
37 |
37 |
37 |
|
Uptake for pembrolizumab + FOLFOX (%) |
3 |
8 |
12 |
13 |
13 |
13 |
|
Uptake for pembrolizumab + XP (%) |
1 |
2 |
2 |
3 |
3 |
3 |
|
Total uptake for pembrolizumab + chemotherapy (%) |
11 |
32 |
48 |
53 |
53 |
53 |
The uptake for pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy is based on company and NHSE estimates. Eligible population includes population growth.
Treatment options for the eligible population
The comparator treatments for the eligible population are platinum- and fluoropyrimidine-based chemotherapy and nivolumab with platinum- and fluoropyrimidine based chemotherapy. All treatment options involve at least 1 component that is administered by intravenous infusion. Pembrolizumab with chemotherapy is expected to be given for more cycles than chemotherapy alone but fewer than nivolumab with chemotherapy.
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 pembrolizumab available to the NHS with a discount.
Users can input the confidential price of pembrolizumab 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. Population growth across the time period leads to increases in capacity impact.
| Capacity impact | Current practice | 2024 to 25 | 2025 to 26 | 2026 to 27 | 2027 to 28 | 2028 to 29 |
|---|---|---|---|---|---|---|
|
Number of administration appointments |
12,600 |
12,500 |
12,600 |
12,500 |
12,700 |
12,800 |
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
| Time from publication to routine commissioning funding |
90 days |
|---|---|
| Programme budgeting category |
02B cancer, upper GI |
| Commissioner(s) |
NHS England |
| Provider(s) |
NHS hospital trusts |
| Pathway position |
First line |
About this resource impact summary report
This resource impact summary report accompanies the NICE technology appraisal guidance on pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy for untreated advanced HER2 negative gastric or gastro-oesophageal junction adenocarcinoma and should be read with it. See terms and conditions and on the NICE website.
ISBN: 978-1-4731-6539-7