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Arthritis patients 'face a life of pain' from drug rationing
Last updated at 22:52pm on 11.11.07
Drug rationing could lead to increased pain and distress for arthritis sufferers
Severe restrictions on the use of effective drugs will ruin the lives of patients with ankylosing spondylitis, they claim.
Only two out of three potential treatments are being approved for NHS use by the National Institute for Health and Clinical Excellence.
And patients who fail to respond to one will not be allowed to switch to the other.
The two approved drugs are at least £5,000-a-year cheaper than the rejected one - but many patients say the more expensive drug has transformed their quality of life.
All three treatments have been available in Scotland - to Scottish patients only - for at least a year.
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Around 200,000 people in the UK have been diagnosed with ankylosing spondylitis.
Sufferers of the arthritic condition - which affects the spine but can also flare up in joints, tendons and ligaments - include former England cricket captain Michael Atherton.
The National Institute for Health and Clinical Excellence - commonly known as NICE - will let severely affected patients use the drugs adalimumab and etanercept.
But the rationing watchdog, which makes its decisions by balancing cost against effectiveness, has rejected the more expensive infliximab.
The two cheaper drugs, which are injected at home, cost around £10,000 a year.
Infliximab, which is given through a drip in hospital, can cost more than £15,000.
The arthritis drugs are the latest in a long line of vital treatments to be freely available north of the border, but restricted in England and Wales.
Scotland uses a different system for evaluating the cost-effectiveness of drugs, sparking claims of "medical apartheid".
Earlier this year the Scottish equivalent of NICE approved Macugen and Lucentis to treat age-related macular degeneration - the most common cause of blindness in the elderly.
But in England, NICE turned down Macugen completely.
It ruled that Lucentis could be prescribed only if a patient had gone blind in one eye and was in severe danger of losing the sight in the other.
Many other drugs have fallen foul of NICE in recent months, including treatments for Alzheimer's disease and osteoporosis.
Jane Skerrett, director of the National Ankylosing Spondylitis Society, said: "NICE's decision is devastating news.
"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 are considering making an appeal later this week, Mrs Skerrett said.
She added: "If there is an appeal, NICE needs to act to ensure that the appeal process does not result in further delays in patients accessing the drugs they need to manage their condition.
"It is shocking that it has taken over three years for NICE to review these treatments - during which time many patients have been denied the treatments by their primary care trust."
The approval of adalimumab and etanercept should remain in place while the appeal is heard, she added.
