Selective internal radiation therapy (SIRT) (radioembolisation (RE))

NHS Arden and Greater East Midlands Commissioning Support Unit (AGCSU), on behalf of NHS England (referred to as the Commissioner), is inviting suitably qualified and experienced suppliers to respond to this Market Engagement exercise relating to the delivery of Selective internal radiation therapy (SIRT), which may also be called radioembolisation (RE), as an option for treating unresectable advanced HCC in adults.

NICE Technology Appraisal 688, (SIRT), approves the use of SIRT (both SIR-Spheres and TheraSpheres products) as an option for treating unresectable advanced HCC in adults, only if the products are:

• used for people with Child-Pugh grade A liver impairment when conventional transarterial therapies (transarterial embolisation and transarterial chemoembolisation) are inappropriate; and
• the company provides SIR Spheres according to the commercial arrangement.

NICE estimated that demand for this treatment will ramp-up over the next two years, reaching a steady state of around 340 patients by 2023/24, from a base of 80 in 2021-22.

Reimbursement will be in 4 parts:

• The work up procedure which groups to the core HRG YR54: Percutaneous Transluminal Embolisation of Peripheral Blood Vessel (1 per patient)
• The treatment procedure which groups to the HRG YR57Z: Percutaneous, Chemoembolisation or Radioembolisation, of Lesion of Liver (estimated to be an average of c1.62 treatments per patient)
• Unbundled radiotherapy SC28Z: Deliver a Fraction of Interstitial Radiotherapy (1 per treatment)
• The cost of the microspheres (1 per treatment)

The first 3 parts will be added to the fixed and variable elements of the 2022/23 Aligned Payment and Incentive agreements with NHS England Specialised Commissioning.

The microspheres can be ordered through NHS Supply Chain as part of NHS England's Specialised Commissioning central procurement route and will be reimbursed via the Visible Cost Model (VCM) which is used for excluded device reimbursement. The estimated value for this contract is £26.7m* over 3 years *based on list price of microspheres.