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NICE seeks views on RA drug

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The National Institute for Health and Clinical Excellence is seeking views on draft guidance on the use of abatacept (Orencia) for rheumatoid arthritis.

NICE suggests the drug should only be considered as an option for treating people if conventional disease-modifying anti-rheumatic drugs have failed.

The manufacturer must also provide the discount agreed in the national patient access scheme, the institute said.

Abatacept is administered as a 30-minute intravenous infusion.

The annual drug costs associated with abatacept vary according to body weight and the number of infusions required. For a person weighing 60-100kg, based on the list price, the cost is £12,700 in the first year, and £11,793 in subsequent years.

Professor Carole Longson, director of the Health Technology Evaluation Centre at NICE, said: “This draft guidance resulting from the rapid review of [the NICE guideline] TA234 provisionally recommends that abatacept could be a treatment option at an earlier stage in the treatment pathway: after treatment with conventional drugs has failed.

“We have already recommended the TNF inhibitors adalimumab, etanercept, infliximab, certolizumab pegol and golimumab, and also the drug tocilizumab, for some people with rheumatoid arthritis as options for use at this stage.”

She added: “The draft guidance could potentially widen the choice of treatments available at this stage of the treatment pathway, by offering abatacept in specific clinical circumstances, and only if the manufacturer provides it with the discount agreed as part of the patient access scheme. We welcome comments on these draft recommendations as part of the consultation.”

NICE has previously recommended abatacept and other drugs as an option for people with rheumatoid arthritis if there has been an inadequate response to one or more TNF inhibitors and who cannot receive rituximab because it is contraindicated or withdrawn because of an adverse event.

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