Patients with severe rheumatoid arthritis are being denied access to effective drugs in spite of guidance from the UK’s clinical- and cost-effectiveness body, the National Institute for Health and Clinical Excellence, backing their use on the country’s NHS, according to new research commissioned by the British Society for Rheumatology and the Arthritis and Musculoskeletal Alliance.

One hundred and forty-eight rheumatology units across the UK were questioned in the survey, which found that 31% of doctors were unable to provide the immune modulating therapies to all qualifying patients, with more than 50% citing lack of funding for the reason. Furthermore, doctors estimate that nearly 1,700 RA patients who could benefit from the drugs are being denied treatment.

A similar survey carried out in 2003 – just one year after NICE backed the use of the therapies, which work by inhibiting the action of an inflammatory mediator known as tumour necrosis factor [[25/03/02a]] – showed that around 33% of doctors were unable to prescribe the drugs to all qualifying RA patients.

In addition, the latest survey found that many doctors were unable to people with other arthritis-related conditions, such as ankylosing spondylitis and psoriatic arthritis, with anti-TNFa treatments despite the clear benefits of doing so. NICE is developing guidance on these treatments, but in the meantime the lack of approval from NICE is the main barrier to treating AS and PSA with these drugs.

Professor David Isenberg, a rheumatologist and president of the British Society for Rheumatology, deemed the results “very disappointing”. “NICE guidance was developed to combat this type of inequality, but it isn’t working for all of our patients. It is wrong that some people are being left with unnecessary pain and disability. The Department of Health should remind health trusts they need to take urgent and immediate action to ensure people get the treatment they are entitled to,” he added.