Thousands of arthritis patients denied drug after treatment is ruled too expensive

Thousands of patients worst hit by rheumatoid arthritis will be denied a "last chance" treatment because the Government's rationing body says it is too expensive.

Orencia is licensed for use in patients who have failed to respond to other medication, including the most advanced current drugs.

An estimated 3,500 of the most badly disabled sufferers in England and Wales are affected by yesterday's ruling from the National Institute for Health and Clinical Excellence.

It is the final decision by NICE, which turned down appeals from the British Society for Rheumatology, the National Rheumatoid Arthritis Society, the Royal College of Physicians, the Royal College of Nursing and drug makers Bristol-Myers Squibb.

Campaigners claim the ruling means the UK is the only major European country to rule against state funding for the treatment.

Trials have shown patients who fail to respond to other drugs known as anti-TNF (tumour necrosis factor) have reduced joint damage and less pain after taking Orencia, also known as abatacept.

Dr Andrew Bamji, president of the British Society for Rheumatology and consultant at Queen Mary's Hospital, Sidcup, South-East London, said: "This is an extremely disappointing decision. Abatacept is not like other biologic agents as it works in a different way.

"NICE is effectively denying desperate patients any last hope of remission from their disease. This decision is a kick in the face for a group of severely disabled patients."

Dr Bamji said patients would have to take their cases individually to Primary Care Trusts for NHS funding.

He added: "The Government has stated clearly that a negative NICE decision does not prevent doctors from prescribing licensed drugs.

"However, it will mean that individual patients and consultants will have to fight very hard with cash-strapped PCTs for this treatment."

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said:

"In rejecting our appeals NICE has condemned people with severe rheumatoid arthritis, who have already failed on other therapies, to a lifetime of misery.

"For many patients abatacept provides their last chance of controlling the disease.

"Without this drug, people with severe RA will have to return to medicines they have already failed on or will have to take large doses of steroids which are associated with extremely unacceptable side effects.

"We believe this is a perverse and very short-sighted decision by NICE.

"Palliative care and the burden of ongoing disability associated with severe RA will result in much greater costs for the NHS than a clinically proven treatment which can make a significant difference to the quality of life of people with severe rheumatoid arthritis."

The manufacturer says the drug costs on average about £10,000 a year compared with £9,000 for anti-TNF drugs. Richard Marsh of Bristol-Myers Squibb said:

"This will be a disappointing decision for many patients."

NICE chief executive Andrew Dillon said:

"The independent appraisal committee who developed the recommendations took into account the severity of the disease when assessing the evidence, as well as the value placed on the benefits of abatacept by people with rheumatoid arthritis, those who represent them, and clinical specialists, but found that abatacept does not represent a good use of NHS resources.

"They have, however, recommended that patients currently receiving the drug for rheumatoid arthritis should have the option to continue therapy until they and their clinicians consider it appropriate to stop."