Patients with rheumatoid arthritis have gained ready access to a new treatment option for their disease after the National Health Service cost watchdog issued a final green light for UCB Pharma’s Cimzia.

The National Institute for Health and Clinical Excellence has now published final guidance recommending Cimzia (certolizumab pegol) as an option for patients with RA, but only in those who have already tried methotrexate and another disease-modifying anti-rheumatic drug (DMARD) and have severe ‘active’ disease.

Cimzia was approved in Europe in October last year after clinical data showed that the drug – which is the first PEGylated anti-TNF therapy to be launched in the UK – significantly improves the signs and symptoms of RA for at least two years, and is also able to halt the progression of joint damage for at least 100 weeks.

Accepting its effectiveness as a treatment for severe forms of the disease, NICE ruled that, with a price tag of around £9,295 a year (£10,725 for the first including a loading dose), the therapy is also a cost-effective use of resources, but only alongside a patient access scheme proposed by the UCB - under which it picks up the tab for the first 12 weeks of treatment.

Cimzia will be competing with other TNF inhibitors already approved by the Institute – namely Johnson & Johnson/Schering-Plough’s Remicade (infliximab), Abbott Laboratories’ Humira (adalimumab) and Amgen/Wyeth's Enbrel (etanercept) – but it does offer patients with RA in the UK a new treatment option for managing the disease and comes with the advantage of being available in an innovative pre-filled syringe, designed to address challenges such as limited dexterity patients face when self-injecting.

£1.8 billion cost to economy
Publication of the guidance comes hot on the heels of a damning ministerial report into RA services in England, which claims that, since 2003, the average time from the first appearance of symptoms to diagnosis has remained at nine months. “Such delay can have enormously serious consequences for the patient: such as disability, damage to heart and lungs, inability to work and a significantly shorted life expectancy,” warned Edward Leigh MP, Chairman of the Committee of Public Accounts.

Starting treatment within three months after symptom onset can halt disease progression which, aside from the substantial benefits to patient health, could also alleviate some of the heavy burden the disease places on the economy and NHS resources; the annual healthcare bill to the NHS is £560 million, with costs to the economy of £1.8 billion from sick leave and work-related disability, according to the report.

To promote earlier diagnosis of the disease the Department of Health should launch a public education campaign highlighting its symptoms and the importance of seeking medical help without delay, Leigh said. In addition, the report emphasised that patients with RA see a family doctor an average of four times before being referred to a specialist, and stressed the need for better GP training to help encourage earlier diagnosis.