PRESS RELEASE – Friday 19 June
Access to disability-preventing drugs remain unchanged but NICE misses opportunity to improve
patient care
The National Institute for Health & Care Excellence (NICE) today released the Appraisal Consultation
Document (ACD) on biologic DMARDS used in the treatment of Rheumatoid Arthritis (RA) for public
consultation.
Biologics are a new generation of medicines offering improved ways to treat RA by targeting
particular chemicals or cells involved in the body’s immune system. There are approximately
690,000 people in the UK living with RA.
The main recommendation of the ACD supports the current position that the drugs remain available
only to those most severely affected. In the early stage of this appraisal process there were concerns
that NICE was considering removing approval for all these drugs for use in the NHS after a recalculation of cost-effectiveness but we are pleased that the appraisal committee has taken into
account the additional evidence that supported the case for their continuing use.
We believe however that NICE has missed an opportunity to extend the use of these drugs for
people with moderate disease who experience the same painful and debilitating symptoms of RA.
These treatments could restore quality of life and enable people to remain in work, help look after
their families and contribute fully to society.
Ailsa Bosworth, Chief Executive of NRAS said, “Our helpline hears just how bad it can be for people
in the moderate to severe category unable to access biologic therapy, so now we know this is as
cost-effective as treating severe disease there can be no excuse to keep the restriction”.
This position means that the UK remains an outlier in Western Europe where there is greater access
to these drugs. We believe that there is no economic or clinical justification for this to continue as
the NICE ACD clearly shows that the formula used to demonstrate cost-effectiveness for the NHS
gives very similar results for both severe and moderate patient groups.
Professor Simon Bowman, President of the BSR, noted that “it is false economy not to treat patients
with moderate disease with biologic therapy when standard DMARDS fail as these patients will be
higher users of healthcare resources. These patients will require more attendance to primary and
secondary care, and are more likely to develop co-morbidities such as osteoporosis, heart disease
and have more surgery.”
They are also much more likely to lose their jobs causing financial hardship and some may also face
earlier mortality, as uncontrolled disease decreases life-span by 6 – 10 years. The personal costs to
the individual, the NHS, the impact on the rest of their family and the direct cost to the exchequer in
lost productivity and benefits claims is massive.
Judi Rhys, Chief Executive of Arthritis Care added: “the impact of RA on people’s lives is overlooked
and underestimated. At present only those with severe RA are treated, partly because NICE does
not take account of costs such as reduced hospital bed days or the benefit of people getting back
into work. We believe that those with moderate RA require better access to these drugs, not only
will it improve lives but it also makes economic sense.”
NOTES TO EDITORS
For further details, please contact:
Laura Guest, BSR - 0207 842 0904
Ailsa Bosworth, NRAS - 01628 823524
Nikki Hill, Arthritis Care - 020 7380 6565