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# **NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE** 

## **HEALTH TECHNOLOGY APPRAISAL PROGRAMME** 

## **Equality impact assessment – Guidance development** 

## **STA pembrolizumab plus chemotherapy with or without bevacizumab for persistent, recurrent or metastatic cervical cancer** 

The impact on equality has been assessed during this appraisal according to the principles of the NICE equality scheme. 

## **Final appraisal determination** 

(when an ACD issued) 

1. Have any additional potential equality issues been raised during the consultation, and, if so, how has the committee addressed these? 

Several potential issues were raised during consultation: 

- The company raised the potential equality issue of metastatic cervical cancer being more common among people with low socioeconomic status as well as ethnic minority groups and migrants who have low engagement with vaccination and screening programmes However, issues relating to differences in prevalence or incidence of a disease cannot be resolved in a technology appraisal. In addition, as the committee‘s decision is for the full population in the marketing authorisation, equality of access across England and socio-economic groups was not considered an equality issue to be addressed by committee. 

- The patient expert submissions highlighted that there was unequal access to pembrolizumab plus chemotherapy with or without bevacizumab for people with private healthcare insurance in comparison to those without. However, NICE’s standard approach to economic modelling (the ‘reference case’) does not compare NHS healthcare with privately funded healthcare. The committee concluded that pembrolizumab plus chemotherapy with or without bevacizumab 

Technology appraisals: Guidance development Equality impact assessment for the single technology appraisal of pembrolizumab plus chemotherapy with or without bevacizumab for persistent, recurrent or metastatic cervical cancer 1 of 3 Issue date: May 2023 



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||met the criteria for inclusion in the Cancer Drugs Fund and|
|---|---|
||recommended it for use within the Cancer Drugs Fund.|
|||
|2.|If the recommendations have changed after consultation, are there|
||any recommendations that make it more difficult in practice for a|
||specific group to access the technology compared with other groups?|
||If so, what are the barriers to, or difficulties with, access for the|
||specific group?|
|No.||
|||
|3.|If the recommendations have changed after consultation, is there|
||potential for the recommendations to have an adverse impact on|
||people with disabilities because of something that is a consequence of|
||the disability?|
|No.||
|||
|4.|If the recommendations have changed after consultation, are there|
||any recommendations or explanations that the committee could make|
||to remove or alleviate barriers to, or difficulties with, access identified|
||in questions 2 and 3, or otherwise fulfil NICE’s obligations to promote|
||equality?|
|No.||
|||
|5.|Have the committee’s considerations of equality issues been|
||described in the final appraisal determination, and, if so, where?|
|Yes.|The description of equality issues was described in section 3.16 of the|
|FAD.||



## **Approved by Associate Director (name):** …Janet Robertson…… 

Technology appraisals: Guidance development 

Equality impact assessment for the single technology appraisal of pembrolizumab plus chemotherapy with or without bevacizumab for persistent, recurrent or metastatic cervical cancer 2 of 3 Issue date: May 2023 



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## **Date:** 08 March 2023 

Technology appraisals: Guidance development Equality impact assessment for the single technology appraisal of pembrolizumab plus chemotherapy with or without bevacizumab for persistent, recurrent or metastatic cervical cancer 3 of 3 Issue date: May 2023 

