UK cost-effectiveness body the National Institute for Health and Clinical Excellence has given the thumbs up for use on the National Health Service of Wyeth/Amgen’s Enbrel (etanercept) and Serono’s Raptiva (efalizumab) in adult patients with severe plaque psoriasis.

The move will be welcomed by thousands of UK patients who have reached the end of the line in terms of treatment options for this chronic disease, which recent data has shown can have the same impact on quality of life as diabetes or even heart disease.

Up to 30% of psoriasis patients suffer from psoriatic arthritis, which is characterized by pain, stiffness and swelling in and around the joints, and NICE has also given its backing for use of Enbrel and Schering-Plough/Johnson & Johnson’s Remicade (infliximab) in this setting.

The companies will be hoping that healthcare systems around Europe will be influenced by the agency’s decision to recommend the use of these targeted biological therapies for treatment of the disease. But many experts have expressed concern that patients across Europe could still be denied treatment with this newest class of drugs on problems with funding.

“It is now vital that healthcare providers take note of the positive NICE decision, the opinion of dermatologists and the needs of psoriatic patients, and make funding for these therapies available as quickly as possible," noted Stevo Knezevic, Chief Medical Officer of Wyeth Europa.

Taxotere for early breast cancer

NICE is also recommending use of the Taxotere (docetaxel) based combination chemotherapy TAC (Taxotere, cyclophosphamide and doxorubicin) on the NHS for women with early node-positive breast cancer.

Sanofi-Aventis’ Taxotere is the only taxane chemotherapy recommended by NICE for treatment of node positive early breast cancer, but final guidance is yet to be published. Praising the drug’s effectiveness, David Miles, Consultant Oncologist at London Bridge Hospital, said: “Results from numerous clinical trials confirm that Taxotere-containing regimens (including TAC) are the foundation for effective treatment strategies at every stage of breast cancer.”

The Scottish Medicines Consortium endorsed the use of the drug in this setting back in October 2005, fuelling the argument that NICE takes too long to reach decisions on potentially life-saving drugs.

“If Taxotere is routinely available in the UK, it has the potential to prevent the deaths of hundreds of women with breast cancer each year," Dr Miles said and, according to Sanofi-Aventis, TAC could save an additional six lives for every 100 patients treated and cuts the risk of cancer recurrence by around 30%.

Rejects paclitaxel

But the news was not so good for paclitaxel, as it looks as though NICE will not be recommending use of the drug on the NHS as an adjuvant for the treatment of early-node breast cancer. In a Final Appraisal Determination, the organisation says it made its decision on a lack of evidence to show that the agent is superior in terms of cost effectiveness and efficacy to current standard therapy.