The National Institute for Health and Care Excellence has not recommended funding the use of Celgene’s Otezla on the National Health Service in England and Wales to treat psoriatic arthritis.

In draft guidelines out this morning (Friday), the cost regulator rejected the drug alone or in combination with disease-modifying antirheumatic drug (DMARD) therapy for treating adults with active psoriatic arthritis that has not responded to prior DMARD therapy, or it is not tolerated.

NICE’s Expert Review Committee concluded that the incremental cost effectiveness ratios for Otezla were “substantially over £30,000 per QALY gained” and thus outside the range normally considered to be a cost effective use of NHS resources (up to £20,000-£30,000 per QALY gained).

The guidelines are now out for consultation, with a deadline for comments of July 10.

NICE's decision marks the second blow for Otezla this month, after having also been turned down in draft guidelines for NHS use as a treatment for chronic plaque psoriasis.