Resource impact summary report
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
Zanubrutinib can be used as an option to treat relapsed or refractory mantle cell lymphoma in adults who have had 1 line of treatment only. Zanubrutinib can only be used if the company provides it according to the commercial arrangement.
Use the least expensive option of the available treatments (including zanubrutinib and ibrutinib), having discussed the advantages and disadvantages of the available treatments. When considering the costs, take account of administration costs, dosages, price per dose and commercial arrangements.
This recommendation is not intended to affect treatment with zanubrutinib 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 healthcare professional consider it appropriate to stop.
Eligible population for zanubrutinib
Table 1 shows the population who are eligible for zanubrutinib and the number of people who are expected to have zanubrutinib in each of the next 5 years, including forecast population growth.
| Eligible population and uptake | People eligible for zanubrutinib | Uptake for zanubrutinib (%) | People starting treatment each year (if applicable) | People continuing treatment from previous years (if applicable) | People having zanubrutinib each year |
|---|---|---|---|---|---|
|
Current practice without zanubrutinib |
234 |
0% |
0 |
0 |
0 |
|
Year 1 |
236 |
25% |
59 |
0 |
59 |
|
Year 2 |
238 |
50% |
119 |
59 |
178 |
|
Year 3 |
240 |
50% |
120 |
178 |
298 |
|
Year 4 |
242 |
50% |
121 |
239 |
360 |
|
Year 5 |
245 |
50% |
122 |
241 |
363 |
The following assumptions have been used to calculate the eligible population:
-
the incidence of mantle cell lymphoma in England is around 520 people per year
-
44.84% of these people will have relapsed or refractory mantle cell lymphoma and will have had 1 line of therapy
The annual uptake of zanubrutinib is projected to be 50% by year 2, based on NICE's assumption of comparable efficacy.
Treatment options for the eligible population
The comparator treatment for the eligible population is ibrutinib. Both zanubrutinib and ibrutinib are administered orally.
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 zanubrutinib available to the NHS with a discount.
Users can input the confidential price of zanubrutinib 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
Evidence for zanubrutinib used in clinical practice also supports that zanubrutinib is likely to work as well as ibrutinib for this population and both treatments are administered orally.
The estimated treatment duration for zanubrutinib is 27.0 months, compared with 14.4 months for Ibrutinib. This is expected to lead to an increase in oral chemotherapy prescription appointments and oncology follow-up appointments.
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 |
30 days |
|---|---|
| Programme budgeting category |
PBC 012X |
| Commissioner |
NHS England |
| Providers |
NHS hospital trusts |
| Pathway position |
Second line |
About this resource impact summary report
This resource impact summary report accompanies the NICE technology appraisal guidance on zanubrutinib for treating relapsed or refractory mantle cell lymphoma and should be read with it.
ISBN: 978-1-4731-7110-7
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