Patients with Crohn’s disease unable to take conventional therapies can now get routine access to Abbott’s Humira and Schering-Plough’s Remicade after cost regulators approved the drugs for National Health Service use.
The National Institute for Health and Clinical Excellence has issued final guidance this week endorsing Humira (adalimumab) and Remicade (infliximab) as options for the treatment of severe, active Crohn’s disease on the NHS, but only when patients are unable to take standard therapies such as immunosuppressants or corticosteroids.
Crohn’s disease is estimated to affect around 60,000 people in the UK, and Dr Carole Longson, Health Technology Evaluation Centre Director at NICE, said the Institute’s review of the evidence “indicates that infliximab and adalimumab are clinically and cost effective options for some people with the most severe forms of the illness”.
“As there is currently no cure for Crohn’s disease, ensuring that patients have access to effective treatments that will help maintain control of their disease is crucial,” noted Dr James Lindsay of Barts and the London NHS Trust.
While the drugs are largely considered to be equal in terms of clinical effectiveness – both showing in trials an ability to induce remission and subsequently prevent relapse – there is a difference in cost; Remicade’s price tag is around £12,584 a year, depending on the patient’s body weight, while induction treatment with Humira is around £1,073 and subsequent maintenance therapy around £9,295 a year.
Doctors should, therefore, pick whichever works out to be the cheaper therapy in each individual case in order to ensure that the NHS is getting best value for money, particularly as the bill can vary because of different modes of administration and treatment schedules, and the Institute also stressed that both drugs should be given as a planned course of treatment until treatment failure or until 12 months after the start, whichever is shorter, to cut back on unnecessary expense.
Humira is the first anti-TNF therapy cleared by NICE for Crohn’s disease that can be self-injected at home, after special training, and represents “an important advance in managing this serious, debilitating condition and in supporting patient independence,” Lindsay added.
Remicade has also been cleared by NICE as an option for adults with active, fistulising Crohn’s disease, as well as to treat children and young people aged six-17 years old with severe, active forms of the disease.
