nzyme · Capivasertib Implementation Explorer (TA1063)

✓National figures are the published NICE TA1063 base case (resource impact template, 15 May 2025): eligible population, uptake, starts, drug/treatment durations, comparator market shares, adverse-event rates and IM-injection capacity. The sub-national split is modelled — national totals rolled up to the 20 Cancer Alliances (via their constituent ICBs) by adult-female (18+) population, with SCMD provider dispensing shown against the modelled eligible population to expose the implementation gap. Drug spend uses list price only; AstraZeneca's confidential discount is not applied.

View: Latest 12-month snapshot Current annual eligible population vs the most recent 12 months of activity. Adjust the modelled adoption below; actual starts come from SCMD when loaded.

Model assumptions NICE base case · editable

AKT-pathway (PIK3CA/AKT1/PTEN) alteration prevalence 40.8%

NICE base case 40.8% (CAPItello-291, NEJM 2023). TA1063 notes a 40–50% range. Drives the eligible population.

Uptake among eligible patients 50%

Assumed adoption among eligible patients for the modelled case (NICE steady state is 50%). Actual starts come from SCMD when loaded.

Capivasertib packs / patient-year 13.65

NICE: 7.8 × 28-day cycles → 13.65 packs of 64×200 mg. Drives drug spend.

Capivasertib list price / pack £5,850

List £5,850 (64×200 mg). The committee's accepted price reflects a confidential discount — enter it here to see net spend.

England — modelled position (latest 12 months) achievement vs: eligible · expected uptake

Geography Cancer Alliance rank: starts · eligibility gap

Cancer Alliance	Started/yr	Eligible/yr	Capture	Gap

Comparator displacement — share of eligible patients

Current practice

Selected year (Year 3)

Capivasertib + fulvestrant Alpelisib + fulvestrant Everolimus + exemestane

NICE base-case market shares (expert opinion): capivasertib reaches 50% by Year 3, mostly displacing everolimus (78%→40%) and roughly halving alpelisib (22%→10%).

Tolerability — grade-relevant adverse-event rates (CAPItello-291 / SmPC)

Modelled AE-management cost / patient (national prices)

£125

Capivasertib

£656

Alpelisib

£258

Everolimus

Alpelisib's cost is driven by hyperglycaemia (36.7% vs 2.8% for capivasertib) — the toxicity the TA flags as limiting its NHS use. Everolimus carries more stomatitis and anaemia. Capivasertib is the best-tolerated of the three on these events.

Capacity & activity — fulvestrant IM injections and monthly starts (latest 12 months)

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Fulvestrant IM injections (12m)
gross, capi+fulv patients

Derived from started × ~15.6 injections/patient (NICE template: 7.8 fulvestrant cycles × 2 × 250 mg syringes over mean treatment duration). Administered as simple parenteral chemotherapy (HRG SB12Z, £178/attendance) — same admin footprint as alpelisib + fulvestrant; everolimus + exemestane is oral-only.