Arthritis sufferers' anger as drug is denied on NHS

Campaigners reacted angrily yesterday to a decision by the UK medicines watchdog to reject a "last resort" drug for the crippling condition of severe arthritis.

The National Institute for Clinical Effectiveness (Nice) said the drug abatacept (Orencia) showed strong evidence of clinical benefit but its price, at £9,333 per person per year on an average dose, was too expensive.

The National Rheumatoid Arthritis Society (NRAS) said there were 3,500 patients who would qualify for the treatment, which is given after all other drugs have failed. It was highly effective and the same price as other drugs in the same class, known as anti-TNF agents, which had been approved by Nice.

Lynn Love, the director of operations at the NRAS, said: "I cannot understand how Nice have reached this decision. Abatacept is for people who have failed on other biologic agents. Whatever the price, we are talking about so few people who will now have nowhere else to go except back on to treatments which have already failed."

About 400,000 people in the UK have rheumatoid arthritis, of which 10 per cent have a severe form of the disease.

The drug's manufacturer, Bristol-Myers Squibb, submitted evidence showing that about 3,585 patients in the UK would be eligible for treatment with the drug.

Frank Pasqualone, the European vice president of Bristol-Myers Squibb, said the company was "disappointed" with the decision. "[The drug] has been shown to be an effective option for patients with severe rheumatoid arthritis for whom treatment with other biologic therapies is not working. We will be appealing against this decision."

A spokeswoman for Nice said the organisation had approved the anti-TNF agent adalimumab (Humira) on Wednesday. She said abatacept had been refused because it was used at a later stage of the disease process, after the other TNF agents, as an alternative to a different drug, rituximab (Mabthera), which was half the price, at about £4,600 per person per year on an average dose.

Although abatacept was an anti-TNF drug, it was appropriate to compare it with rituximab and not with the other anti-TNFs, because they were used at the same stage of the disease process.

In a statement, Nice said: "Abatacept can cost about twice as much as rituximab, but offers similar benefits. Based on this evidence, abatacept could not be considered a good use of NHS resources."

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