Scottish arthritis sufferers are to receive a powerful pain relief drug even though it may be unavailable to NHS patients in the rest of the UK.
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NICE has provisionally ruled that tocilizumab is too expensive for UK use on the NHS, but the Scottish Medicines Consortium has recommended prescribing it to patients.
Marketed as RoActemra, the drug reduces painful symptoms of arthritis by targeting an inflammatory signalling molecule called interleukin-6, and improves remission rates by six times when used with standard anti-inflammatory methotrexate (MTX).
Tocilizumab costs £9,000 per patient per year, and was judged too expensive in NICE draft guidance, although in December the body challenged the manufacturer Roche to prove the drug was truly cost-effective, and indicated it could change its final decision.
The Scottish guidance says tocilizumab and MTX should be combined to treat moderate to severe rheumatoid arthritis when patients do not respond to other therapies, but currently English and Welsh NHS funding bodies are not obligated to pay for the treatment.
In most of Europe, rheumatoid arthritis sufferers can already use the drug if other drug options have ceased to work.