Rheumatoid arthritis drug which eases pain ‘is too expensive for the NHS’
Thousands of NHS patients with previously untreatable rheumatoid arthritis could be denied a new ‘smart’ drug to ease their agony because it is too expensive.
The drug – the first new medicine for rheumatoid arthritis for ten years – is initially targeted to help patients with moderate to severe disease who have not responded to other types of therapy.
In trials almost one-third of patients went into remission after using tocilizumab for six months, allowing them to lead a normal life. A similar number found treatment dramatically cut their symptoms.
Medical breakthrough: Tests show the drug could dramatically reduced symtoms in arthritis sufferers
However, the cost of treating just one patient is £9,300 per year.
Rheumatoid arthritis, in which the body’s immune system attacks the joints, affects around 646,000 people in the UK, many of whom are severely disabled.
The worst affected are unable to work and the direct and indirect costs of the dis-ease are estimated at £3.8billion to £4.75billion a year.
It is thought almost 40,000 sufferers might be eligible for tocilizumab, marketed as RoActemra, after failing to respond to other drugs.
The drug has been licensed throughout Europe, but the cost has led the Government’s rationing body to issue a preliminary rejection of its use by NHS patients in England.
The move has been condemned by patient groups, who claim severely affected patients will have to use ineffective therapies that will not stop them losing their jobs because of increasing disability.
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Five trials involving more than 4,000 patients found the drug can transform the lives of those who cannot tolerate other therapies or who no longer respond to them.
Six times more patients achieved clinical remission with tocilizumab than with the standard drug treatment methotrexate.
The new drug is a laboratory-manufactured antibody that blocks a molecule called interleukin 6, which is associated with many inflammatory processes.
The injected drug may be given either on its own or in combination with standard anti-rheumatic drugs.
Crucially it offers new hope for patients who can no longer be helped by another family of advanced ‘biologic’ drugs, TNF (tumour necrosis factor) inhibitors.
In patients not responding to methotrexate or anti-TNF drugs, tocilizumab achieved 30 per cent remission rates after six months.
After two years, remission rates of 54 per cent were attained for those not responding to methotrexate.
Professor Paul Emery from the University of Leeds, one of the trial investigators, said: ‘This is one of the most exciting therapies to have emerged in the last decade.
‘Rheumatoid arthritis is an unrelenting disease and it is vital that patients have options available to them when they are no longer responding to, or can no longer tolerate, their current treatment.’
The cost of tocilizumab is similar to anti-TNF drugs, but an initial appraisal by the National Institute for Health and Clinical Excellence says it will not be allowed for NHS use in England. It is due to issue final guidelines early next year.
Separate guidance is expected from NICE’s counterpart in Scotland, the Scottish Medicines Consortium, by the end of this year. It almost always follows NICE’s lead in this area.
Ailsa Bosworth, of the National Rheumatoid Arthritis Society, said: ‘This is extremely bad news for people living with severe rheumatoid arthritis in the UK and a potential step backwards in the management of the condition if this decision is not reversed.’
A spokesman for the drug’s manufacturer, Roche, said it would provide NICE with more information on the clinical and cost-effectiveness of tocilizumab.