NICE Preliminary Decision On Sequential Use Of Anti-TNFs, NICE 'Penny-Pinching' Restricts Patient Choice

Main Category: Arthritis / Rheumatology
Article Date: 30 Apr 2008 - 1:00 PDT

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A leading arthritis charity accused the government's health rationing watchdog of 'penny-pinching' in its decision to refuse thousands of people the chance to try an alternative life-changing anti-TNF drug if a first does not work for them.

'Anti-TNFs can slow down the progress of rheumatoid arthritis. We hear so much about NHS choice but patients and clinicians alike will be frustrated by the decision to limit treatment options in this way. But any supposed saving is false - the human cost alone is enormous, not to mention the cost to society and the economy', said Arthritis Care chief executive Neil Betteridge.

'The decision means that people now only have one option (rituximab) if their anti-TNF doesn't work - and if rituximab fails them too, their disease will progress, causing irreversible damage to their joints, disability, poverty, and a significantly shortened life expectancy. It just robs Peter to pay Paul as they will need higher levels of NHS intervention, more in-patient bed days, more orthopaedic surgery, and probably end up leaving their jobs and having to claim incapacity benefit instead of being active, productive members of UK Inc', he said.

'It is a terrible irony that the current NHS buzzword is 'choice;' but this decision restricts choice not on clinical grounds, but on grounds of cost alone. NICE is supposed to make its decisions on grounds of clinical and cost effectiveness, but on this occasion, penny-pinching has been the deciding factor', he said.

The National Institute for Health and Clinical Excellence (NICE) delivered its body blow in today's decision on the sequential use of anti-TNFs, which, if allowed, would have meant that people in England and Wales could try another drug in the same class if the first treatment did not work.

As each person reacts differently, when prescribing, doctors cannot predict which drug will best suit an individual. But it is known that four out of five people respond to a second anti-TNF therapy. In most parts of Europe, sequential use is not only allowed but recommended.

Arthritis Care