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NICE attacked over negative FAD on anti-TNF therapies in RA

23 Jul 08

The National Institute for Health and Clinical Excellence has issued guidance which again recommends against allowing patients to use a second anti-tumour necrosis factor alpha treatment for rheumatoid arthritis if the first does not prove to be effective.

NICE has issued a Final Appraisal Determination (FAD) guidance, saying that Abbott Laboratories’ Humira (adalimumab), Wyeth's Enbrel (etanercept) and Johnson & Johnson's Remicade (infliximab) should not be available on the National Health Service for the treatment of RA after the failure of a previous anti-TNF inhibitor. At the moment, patients can be prescribed the drugs but NICE has concluded there was insufficient evidence that after a patient failed on one anti-TNF therapy, a second would be clinically effective.

The agency stated that doctors should consider using Roche's MabThera (rituximab), which costs about £3,000 less per year than the anti-TNF drugs, the prices of which can reach £10,000 annually. NICE added that consultees now have the opportunity to appeal, and subject to an appeal being received, final guidance is expected in September.

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