NHS arthritis patients will get a drug originally developed to treat cancer

Labour's 'rationing watchdog' has approved the use of MabThera for patients with severe rheumatoid arthritis.

The drug, also known as rituximab, has been successfully used for almost a decade to treat a form of cancer called non-Hodgkin's lymphoma.

The surprise move comes after other new treatments for the crippling disease - which affects 400,000 Britons - were rejected as too expensive.

But MabThera, which has already been given the go-ahead in Scotland, costs around half as much as these other drugs at just under £5,000 a year.

It was recently hailed by The Lancet as part of a 'new era of treatment' for the 40,000 patients in the UK with severe rheumatoid arthritis.

It was licensed for use last year but primary care trusts have been waiting for approval by the National Institute for

Health and Clinical Excellence to start prescribing the drug.

Trusts now have three months to implement the use of MabThera.

It is expected to help around a third of patients with the most severe form of disease who fail to respond to existing treatments, known as anti-TNF drugs.

These patients suffer relentless pain, fatigue and disability as the autoimmune disease destroys their joints.

Professor Paul Emery, of the University of Leeds, said the drug acts in a unique way by knocking out cells crucial to the inflammatory chain reaction.

"The decision to make this important medication available on the NHS is very good news," he said.

"It will offer patients who fail on anti-TNF therapies a viable alternative where in the past they had no NICE-approved options."

Even though anti-TNFs were approved by NICE five years ago, half of rheumatologists still report funding restrictions on them.

NICE recently proposed to block their use among patients who did not respond to them immediately.

Earlier this month, the watchdog rejected another cutting- edge rheumatoid arthritis drug called Orencia, ruling that it was not costeffective.

The relatively low £4,657 average annual cost of MabThera, made by Roche, is partly because its research and development costs were defrayed when it was launched for cancer patients.

Some anti-TNF treatments can cost twice as much.

Professor Emery said: "The cost is likely to be a factor in its approval, but it's a unique drug. The majority of patients respond, half have a highly significant response without toxic effects, and a single course of treatment can give benefits for nine months.

"This is a lifetime disease that needs lifetime therapy and patients need alternative treatments." The Arthritis Care charity's chief executive, Neil Betteridge, said NICE's decision was a 'triumph'.

"The search for effective treatment can be a long, agonising journey, littered with dashed hopes," he said. "Now there's no excuse for denying this drug on any grounds but clinical.

"NICE is bound to balance cost against benefit. This decision shows that it understands the benefit of expanding the range of choices for individuals who have exhausted other options, and would otherwise face the bleak prospect of palliative care and a return to drugs that have already failed."

A spokesman for the Arthritis Research Campaign charity added: "NICE has been in the firing line a lot recently so they should be given credit for approving the use of rituximab.

"This gives patients with severe rheumatoid arthritis who fail on anti-TNF therapy a lifeline by making available another treatment option.

"It's particularly welcome given NICE's recent draft guidance that another drug for severe rheumatoid arthritis, abatacept (Orencia), was too expensive."