UK patients with psoriatic arthritis are on the brink of gaining access to an additional treatment option on the National Health Service in England and Wales after cost regulator's waved through Merck Sharpe and Dohme's Simponi (golimumab) for psoriatic arthritis (PA).

The National Institute for Health and Clinical Excellence has published final draft guidance recommending Simponi as a cost-effective therapy for active and progressive PA in adults, but only under the same guidelines governing the use of other tumour necrosis factor (TNF) inhibitors available on the NHS, namely Amgen/Pfizer's Enbrel (etanercept), J&J/Merck's Remicade (infliximab) and Abbott Laboratories Humira (adalimumab).

The decision marks quite a turnaround from the cost watchdog's initial position, as the drug was actually turned down for PA in previous draft guidance, on doubts whether it is as effective as treatments already recommended for the condition.

However, additional information subsequently provided by MSD during the consultation helped convince the Institute otherwise, and the offer of a patient access scheme - under which both available doses of Simponi (50mg and 100mg) will be available to the NHS at the lower dose cost - helped sweeten the deal.

Aside from the obvious benefit of having a further option available following the failure of first-line treatment, Carol Longson, Health Technology Evaluation Centre Director at NICE, said "patients may welcome the option of a self-injectable treatment that only has to be administered once a month".

Its once-monthly dosing regimen may give Simponi - which comes in a SmartJect autoinjector or as a prefilled syringe - a competitive edge over the other anti-TNFs used by the NHS, given that Enbrel needs to be injected every week and Humira every-other-week.

A 50mg pre-filled injection pen of SImponi costs £774.58, with the annual price tag estimated to be around £9,294.