The UK’s National Institute for Health and Clinical Excellence (NICE) has backed an earlier use of Orencia in rheumatoid arthritis after manufacturer Bristol-Myers Squibb reduced its price.
Draft NICE guidance now recommends Orencia (abatacept) can be used, in combination with methotrexate, after conventional disease-modifying anti-rheumatic drugs (DMARDs) have failed.
If finalised would bring the drug inline with rival biologics like Humira, Enbrel, Cimzia and Actemra, and it would also reverse NICE’s 2011 assessment that Orencia was not a cost-effective treatment compared with these drugs.
But NICE was only won over after BMS agreed to a patient access scheme with the Department of Health that will see the pharma company supply Orencia to the NHS in England at a discounted price.
NICE also said Orencia could only be used if patients had responded inadequately to two conventional, non-biologic, DMARDS and if it follows NICE’s recommendations for biologics like Humira.
Professor Carole Longson, director of NICE’s Health Technology Evaluation Centre, said: “NICE has already recommended a range of treatments to help patients manage rheumatoid arthritis, which can be a disabling condition.
“The draft guidance could potentially widen the choice of treatments available at this stage of the treatment pathway, by offering abatacept in specific clinical circumstances,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.”
The level of discount BMS offered remains, as is usual in these cases, confidential, and its list price varies according to body weight and the number of infusions required. For a person weighing 60−100 kg, the list price gives an annual cost of £12,700.80 in the first year, and £11,793.60 in subsequent years.
The guidance is now open for consultation and after this closes on January, 10 NICE is expected to issue final guidance on Orencia in this setting in April next year.