UK’s NICE Decision Regarding Arthritis Drugs Curtails Switching Treatments

July 21, 2008 by  
Filed under ARTHRITIS

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The UK’s National Institute for Health and Clinical Excellence (Nice) decision on arthritis drug will prevent tens of thousands of arthritis sufferers to switch to powerful drugs.

In a separate post I already mentioned UK Nice’s ruling that do not allow switching of arthritis drug to more powerful ones, once the patient do not respond in one in the premise that it isn’t cost effective. Now the final draft on that ruling (before definitive guidance is issued) has been issued by Nice already.

Charity groups and arthritis patients alike are going berserk of course, simply because this ruling will prevent access of arthritis patients to hopefully better drugs to manage their arthritis.

The Telegraph reports:

The National Institute for Health and Clinical Excellence (Nice), today issues a final appraisal document – the last draft before definitive guidance is issued – stating that patients who do not respond to one powerful drug cannot try another of the same type.

Currently doctors are able to try patients on three variants of a drug type which work by blocking the action of a chemical.

If one does not work or its effectiveness wears out over time, sufferers can switch to another, prolonging the period they can remain fit and active.

But the drugs are very expensive, with even the cheapest costing around £100 a week per patient.

Many rheumatoid arthritis patients live with the disease for decades. They argue that cutting down the options will leave them needlessly living in agony for years.

Cutting access to the drugs will speed their decline, meaning they are less able to work for a living and will have to rely more on benefits and care, campaigners say.

I don’t understand it either. I came from a country where regular citizens don’t have access to the best treatment just because they don’t have money nor the medical coverage. I always thought thought that in the first world, access to the best treatments and prescribed drugs isn’t a problem. But then I guess it all boils down to business. I don’t know how medical coverage in the UK works, but then I guess since the government seems to have a say in which drug to opt for in the case of anti-TNFs for rheumatoid arthritis, they are probably covering a huge bulk of the medical treatments.

The anti-TNF drugs currently available on the NHS are Enbrel (its generic name being etanercept), Humira (adalimumab) and Remicade (infliximab).

Scientists are not sure why one anti-TNF drug might stop working over time but doctors and patients agree being able to switch between them can be highly beneficial.

Once arthritis patients have exhausted the anti-TNF options, under NHS rules they can move on to another drug called rituximab, a ‘biologic’ which works by modifying the immune system.

Until recently they would have then been able to try a separate drug called abatacept, but in April Nice quashed that option, saying it was not cost effective.

However, it just doesn’t sound fair to declare some drug class to be not cost effective. Then why don’t they just charge the patient with the extra cost they don’t cover?! At least leave the doctors and patients to have more options for treatment, right? I don’t know…I’m just saying.

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