Patient groups take issue with the UK NICE's reassessment of switching on RA drugs and decision on leukemia therapy azacitidine

The UK's National Institute for Health and Clinical Excellence (NICE) yesterday issued a guidance now put out for consultation on using adalimumab (Abbott's Humira), etanercept (Wyeth/Pfizer's Enbrel), infliximab (Schering-Plough/Merck & Co's Remicade), rituximab (Roche's MabThera) and abatacept (Bristol-Myers Squibb's Orencia) for the treatment of rheumatoid arthritis after the failure of a tumor necrosis factor (TNF) inhibitor in the National Health Service in England and Wales.

The decision is to recommend MabThera for use on theNHS, and for Humira, Enbrel and Remicade, to be recommended for the treatment of rheumatoid arthritis after the failure of a previous TNF inhibitor only in the context of research. However, Orencia is not recommended for the treatment of RA after the failure of a TNF inhibitor.

The NICE says that the Appraisal Committee has considered the evidence submitted and the views of non-manufacturer consultees and commentators, and clinical specialists and patient experts. Nevertheless, once again its findings have raised objections not only from the drugs' producers but also patient groups.