A novel treatment option for some patients with rheumatoid arthritis (RA) could soon be routinely available on the NHS, after cost regulators ruled Eli Lilly’s Olumiant to be cost-effective.
Draft guidelines by the National Institute for Health and Care Excellence recommend Olumiant (baricitinib) as an option for treating severe active RA in adults whose disease has responded inadequately to intensive therapy with conventional disease-modifying antirheumatic drugs (DMARDs).
The drug is also recommended in adults who have had an inadequate response to, or who cannot have other DMARDs, including at least one biological DMARD.
Olumiant was approved earlier this year as the first JAK inhibitor to treat rheumatoid arthritis, after clinical trials showed a significant improvement in the signs and symptoms of disease compared to standard of care therapies.
Data from the Phase III RA-BEAM trial showed that baricitinib scored significantly better than placebo on the ACR20 response, a standard clinical measure that represents at least a 20 percent improvement in RA disease activity, as well as demonstrating superiority to AbbVie’s multi-billion-dollar blockbuster Humira (adalimumab), the world’s biggest selling drug.
After 24 weeks, the drug was also superior to placebo in preventing progressive radiographic structural joint damage, and its treatment benefits were maintained through 52 weeks of therapy.
In the RA-BEGIN trial, the drug also outperformed methotrexate on the ACR20 measure while, elsewhere, data showed efficacy in RA patients with inadequate responses to traditional disease-modifiying anti-rheumatic drugs (in the RA-BUILD trial) and biological therapies (in RA-BEACON).
RA affects around 450,000 people in the UK, of whom around 15 percent have the severe form of the disease.
The average cost of Olumiant per patient per year is estimated at £10,501 based on the list price, but its cost to the NHS will be reduced through a confidential patient access scheme.