Celltrion Healthcare is calling on the NHS to consider lowering the threshold for starting biologics in patients with rheumatoid arthritis (RA), and to put in place measures to boost patient access to such treatment.

The thresholds in disease activity set as a starting point for use of biologics vary across Europe, as does the percentage of patients treated with an anti-TNF-alpha, which is 24% or higher in countries such as Italy and France but just 15% in the UK.

This is because in the UK a patient must have a disease severity score of 5.1 before treatment can be initiated, compared to only 3.2 in other European countries, the firm said.

“Despite the National Institute for Health and Care Excellence (NICE) widely acknowledging that appropriate biological treatments are clinically effective for all subgroups of RA patients, access to these therapies remains restricted in UK on grounds of cost-effectiveness,” it argues.

“A UK patient’s burden of disease must be much more severe before they qualify for biologic therapy, compared to a French patient. As a treating physician, I strongly believe that this inequality needs to be addressed so that our patients can realise the same benefits of early treatment as their European neighbors,” noted Dr Ben Parker, consultant rheumatologist, Manchester University Hospitals, NHS Foundation Trust, speaking at the Health and Care Innovation Expo 2018.

Celltrion, which makes biosimilar infliximab, points to recent data showing that NHS England saved £324 million in the last financial year by switching from using 10 higher priced medicines to better value biosimilars and generic medicines which are considered to be equally effective and safe alternatives.

“Switching patients to biosimilars of these biologics led to significant cost savings: infliximab biosimilars delivered £99.4 million in savings, etanercept biosimilars delivered £60.3 million, and rituximab biosimilars delivered £50.4 million, for a cumulative savings of over £220 million in cancer and autoimmune diseases such as rheumatoid arthritis and inflammatory bowel diseases,” the group said.

“Patients diagnosed with less than severe disease activity should be able to get just as good and cost-effective benefit from biologics as patients with severely active disease, as this will help them achieve a better quality of life,” added Mr HoUng Kim, head of strategy and Operations at Celltrion.

“With the proven savings, gained through the use of biosimilars, this could be a real opportunity for the NHS to address these concerning inequalities.”