NICE Guidance: Arthritis Drug Funding Should Stop

A controversial draft guidance has today been issued by the National Institute for Health and Clinical Excellence, in respect of the rheumatoid arthritis drug Orencia. The institute highlights within this how the medicine is not economically viable and represents poor value for money. On this basis, it states, its funding on the NHS should be terminated – a proposal that has incensed campaigners who argue that its benefits far outweigh the cost. In the words of the National Rheumatoid Arthritis Society, today’s announcement comes as “devastating news”.

Rheumatoid Arthritis is a disease which, in its severe form, is present within an estimated 40,000 people in this country. It occurs when the joints come under attack from the immune system, leading to swelling and damage to bone and cartilage. The usual treatment given to sufferers of this extremely painful and debilitating condition is known as an ‘anti-TNF’. However, in approximately 30 per cent of cases, these standard drugs prove ineffective. This is where the debate surrounding Orencia kicks in, given that, as highlighted by the National Rheumatoid Arthritis Society, the drug has the potential to offer hope to up to 12,000 UK sufferers.

Orencia is manufactured by Bristol-Myers Squibb, which places a lower figure on the drug’s beneficiaries, but still believes more than 3,500 people could qualify for it.

In the eyes of the Chief Executive of the NRAS, Ailsa Bosworth, to remove a treatment of this significance from the marketplace would be wrong. In the absence of Orencia, those with severe rheumatoid arthritis would be left with either resorting to treatments which they had previously not responded to, or instead being prescribed steroids en masse. This latter option, however, she added, carries with it an ultimate risk of long-term side effects, of which one is osteoporosis.

One solution to the cost element of the drug, she suggested, was that those patients in which Orencia was not working could minimise their intake of it – in this way ensuring costs are kept as low as possible. In conclusion, though, Ms Bosworth stated: "We simply cannot accept that individuals should be denied the chance of at least regaining some quality of life and condemning them to a life of pain and disability, which could be equally as expensive to the NHS."

A spokeswoman from NICE confirmed that today’s decision followed a period of assessment, in which an independent advisory committee had found Orencia to represent poor value for money. It should be noted that the guidance, at this stage, is not definitive; a final verdict is however, anticipated to emerge before year-end.

Source – Pharmaceutical International’s Health Reporter