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

## **HEALTH TECHNOLOGY APPRAISAL PROGRAMME** 

## **Equality impact assessment – Guidance development STA Avelumab for metastatic Merkel cell carcinoma** 

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

## **Consultation** 

1. Have the potential equality issues identified during the scoping process been addressed by the committee, and, if so, how? 

No equality issues have been identified during the scoping process. 

2. Have any other potential equality issues been raised in the submissions, expert statements or academic report, and, if so, how has the committee addressed these? 

In a clinical expert statement, a potential equality issue was identified for poorer people. It was reported that the rarity of Merkel cell carcinoma would cause patients to be managed in specialist centres and therefore would disadvantage poorer people because of the cost of travel. The committee assessed this was not likely to be an issue as clinicians would get more experienced with treating the condition and will move across hospitals rather than staying in the main specialist centres. No potential equality issues have been raised in the submissions or academic report. 

3. Have any other potential equality issues been identified by the committee, and, if so, how has the committee addressed these? 

No potential equality issues have been identified by the committee. 

Technology appraisals: Guidance development 

Equality impact assessment for the single technology appraisal of avelumab for metastatic Merkel cell carcinoma 1 of 4 




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4. Do the preliminary recommendations 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. 5. Is there potential for the preliminary recommendations to have an adverse impact on people with disabilities because of something that is a consequence of the disability? No. 6. Are there any recommendations or explanations that the committee could make to remove or alleviate barriers to, or difficulties with, access identified in questions 4 or 5, or otherwise fulfil NICE’s obligations to promote equality? Not applicable. 7. Have the committee’s considerations of equality issues been described in the appraisal consultation document, and, if so, where? Not applicable. **Approved by Associate Director (name):** Janet Robertson **Date:** 20 November 2017 

Technology appraisals: Guidance development Equality impact assessment for the single technology appraisal of avelumab for metastatic Merkel cell carcinoma 2 of 4 Issue date: April 2018 



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## **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? 

The company suggested that putting second line and beyond treatment with avelumab into the Cancer Drug Fund will prevent access of the drug to patients in Wales and Northern Ireland who cannot benefit from the fund. 

The committee recommended the use of avelumab after one or more lines of previous chemotherapy for routine commissioning. 

It is not within NICE’s remit to consider access to technologies in Wales and Northern Ireland. 

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. 

Technology appraisals: Guidance development 

Equality impact assessment for the single technology appraisal of avelumab for metastatic Merkel cell carcinoma 3 of 4 Issue date: April 2018 



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|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?|
|Not|applicable.|
|||
|5.|Have the committee’s considerations of equality issues been|
||described in the final appraisal determination, and, if so, where?|
|Not|applicable.|



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

**Date:** 09 April 2018 

Technology appraisals: Guidance development Equality impact assessment for the single technology appraisal of avelumab for metastatic Merkel cell carcinoma 4 of 4 Issue date: April 2018 

