NHS in England Denies Ankylosing Spondylitis Treatment
Posted Jun 05 2010 7:46pm
If you live in the U.K. and suffer from ankylosing spondylitis, you had better live in Scotland.
The National Institute for Health and Clinical Excellence (NICE), the national drug rationing body, has ruled that infliximab, has ruled that the drug is not cost effective. At £15,000 ($30,000) a year it is £5,000 ($10,000) a year more than the two approved drugs, adalimumab and etanercept. In addition, if an AS patient does not respond to the one of those 2 drugs they are prescribed by their physician they will no longer be allowed to switch to the other.
Estimates are that 200,000 people in the UK suffer from ankylosing spondylitis, a form of arthritis that attacks the spine and can also flare up in joints, tendons and ligaments.
Adalimumab and etanercept are injected at home while infliximab is administered in the hospital through an intravenous drip.
These are the latest in a series of treatments that are being disallowed based on NICE’s evaluation of effectiveness vs. cost. Scotland uses a different system for determining the cost effectiveness of drugs.
For example, Scotland’s equivalent of NICE recently approved Macugen and Lucentis for the treatment of age related macular degeneration, which is the most common cause of blindness in the elderly. But NICE in England disapproved Macugen and decreed that Lucentis could only be prescribed to patients that had already lost the sight in one eye and were in severe danger of losing sight in the other.
Jane Skerrett, director of the National Ankylosing Spondylitis Society said: “Essentially they are limiting people with AS to just one out of three potentially life-changing treatments by refusing to approve one treatment and preventing people from switching to another treatment on the grounds of efficacy. The three drugs under review from NICE are the only real treatment options for people with severe ankylosing spondylitis.”
“NICE is condemning people who fail on just one of these advanced therapies to treatment with drugs they have already failed on and a lifetime of pain and disability. There is no alternative effective treatment for patients with severe AS.”
“There are only these three drugs and NICE has effectively cut this to one.”
Arthritis charities in England are considering appealing the NICE ruling.
Infliximab has been approved by the U.S. Food and Drug Administration for the treatment of psoriasis, pediatric Crohn’s disease, ankylosing spondylitis, Crohn’s disease, psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis.