Patients with psoriatic arthritis have been granted access to Janssen’s biologic therapy Stelara on the National Health Service in England and Wales.

The National Institute for Health and Care Excellence has confirmed reimbursement for the drug in new technology appraisal guidance endorsing the treatment for certain patients, marking a u-turn from an earlier decision to bar its routine use.

Doctors can now freely prescribe Stelara, alone or in combination with methotrexate, for treating active psoriatic arthritis in adults who have failed to respond to previous therapy with non-biological disease-modifying anti-rheumatic drugs (DMARD).

The cost watchdog has stipulated that the drug should only be considered when treatment with tumour necrosis factor (TNF) alpha inhibitors is contraindicated but would otherwise be considered, or the person has had treatment with one or more of this class.

NICE’s Committee concluded that, in this subset of patients, the most plausible incremental cost-effectiveness ration was £21,900 per QALY gained.

Psoriasis affects around 1.8 million people in the UK, equating to 2%-3% of the population. "It’s great to have another option for our patients who we currently find challenging to treat, either because they are failing on existing treatments or because the existing therapies are contraindicated or causing undesirable side effects,” noted Dennis McGonagle, Professor of Investigative Rheumatology at the Leeds Institute of Rheumatic and Musculoskeletal Medicine.