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Rheumatology Advance Access originally published online on August 24, 2004
Rheumatology 2005 44(1):3-4; doi:10.1093/rheumatology/keh364
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Rheumatology Vol. 44 No. 1 © British Society for Rheumatology 2004; all rights reserved

EDITORIAL

The NICE reappraisal of biologics in 2005: what rheumatologists need to know

N. J. Bansback, A. Young1 and A. Brennan

Operational Research, School of Health and Related Research, Sheffield S1 4DA and 1 Early Rheumatoid Arthritis Study (ERAS) Co-ordinator, St Albans Hospital, St Albans AL3 5PN, UK

Correspondence to: A. Brennan. E-mail: a.brennan@sheffield.ac.uk

The first 10% of the full text of this article appears below.

In July 2003, the National Institute for Clinical Excellence (NICE) made a decision not to recommend anakinra therapy for use in rheumatoid arthritis (RA) in England and Wales [1]. The cost-effectiveness model used suggests that the additional health gains are simply not worth the additional costs [2]. This has stark implications. Many rheumatologists are currently anticipating a shift in clinical practice towards earlier and sequential use of etanercept, infliximab and adalimumab. In contrast, the anakinra analysis suggests that even the TNF-{alpha} inhibitors may not be cost-effective in comparison with traditional disease-modifying anti-rheumatic drugs (DMARDs) even in the patients with high disease activity for whom they are currently recommended. Rheumatologists must understand and engage in this economic evaluation debate, be aware of important criticisms of the modelling approach and also realise the influence that their . . . [Full Text of this Article]


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