Though it has become routine for the U.K.'s National Institute for Health and Clinical Excellence to reject novel drugs unless or until manufacturers cut a deal that lowers the cost, the agency has set an especially improbable hurdle in lupus. For Benlysta belimumab, NICE has asked for a comparison to MabThera rituximab - an unapproved drug that failed Phase III trials and that Primary Care Trusts are increasingly refusing to pay for.

The agency also said a patient access scheme proposed by sponsor GlaxoSmithKline plc wasn't enough to make the drug cost-effective.