In Great Britain, the National Health Service is the publicly funded government healthcare system. The National Institute for health and Clinical Excellence (NICE) is the board that makes recommendations as to whether particular treatments should be included in the NHS plan, generally based on cost effectiveness.
In April of 2007, NICE recommended that if a rheumatoid arthritis (RA) patient did not respond to 1 of 3 approved anti-tumor necrosis factor (TNF) drugs they could not try one of the others. This caused a loud outcry from patient advocates who believe each person reacts differently and their doctor cannot predict which of the drugs will be the best therapy.
According to the U.K.’s Arthritis Care, these three drugs belong to the same class but they work in slightly different ways. If people don’t respond within six months, their first treatment is discontinued. Research shows that 84 per cent of those who do not respond to one drug are helped by another. However, the only approved reason for switching drugs is a bad reaction, so people could be left high and dry, without any alternative treatment
After months of campaigning by 2,000 members of the National Rheumatoid Arthritis Society, drug companies and patients groups, NICE has agreed to reconsider its previous recommendation.
A spokesman for Nice said: “The decision of the appeal panel reinforces the fact that the appeal process is robust, independent and focused on ensuring that NICE produces guidance in a fair and reasonable way. This appraisal has now concluded. The Institute is seeking advice from the Department of Health as to whether a new formal referral from ministers is required, and will make the decision available once it is known.”
The 3 anti-TNF drugs are adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade).
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