The National Institute for Health and Clinical Excellence (NICE), which decides whether drugs should be paid for on the state-funded National Health Service, had initially only backed the drug MabThera (made by Roche) as a fallback choice. But draft final guidance published on Friday recommends patients should also have the chance to try one of four other drugs if they do not respond to initial anti-tumour necrosis factor (TNF) treatment and cannot take MabThera. The drugs are Abbott Laboratories' Humira; Pfizer and Amgen's Enbrel; Merck & Co and Johnson & Johnson's Remicade; and Bristol-Myers Squibb's Orencia. TNF inhibitors Humira, Enbrel and Remicade were already recommended for use as initial TNF therapy, but Orencia, which works in a different way, had previously been rejected. "Not all patients are able to take rituximab (MabThera), and so, following consultation, the appraisal committee has recommended that adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade) or abatacept (Orencia) may be given in this context if a patient cannot take rituximab," said Carole Longson, NICE director for health technology evaluation. "We hope that this wider choice of options will mean that people will be able to manage their rheumatoid arthritis more effectively," Longson said. |