NICE issues final appraisal for RA drugs

The U.K.'s NICE issued a final appraisal determination for five drugs to treat rheumatoid arthritis (RA) after treatment with a TNF inhibitor has failed. NICE reiterated its recommendation in favor of MabThera rituximab, a mAb against CD20 from Roche (SIX:ROG; OTCQX:RHHBY), and reversed recommendations for four drugs that NICE had previously rebuffed. The drugs -- Humira adalimumab, Enbrel etanercept, Remicade infliximab and Orencia abatacept -- are now recommended for use in patients who responded inadequately to other DMARDs or are unable to receive MabThera or methotrexate (See BioCentury Extra, Wednesday, March 03, 2010).

NICE said the incremental cost-effectiveness ratios (ICERs) for the four drugs compared with MabThera were either very high, or MabThera was more effective and less costly than the four drugs. However, NICE said the four drugs were cost-effective when compared with DMARDs, the appropriate comparator for patients unable to receive MabThera or methotrexate. Orencia, marketed by Bristol-Myers Squibb Co. (NYSE:BMY), is a CTLA-4-Ig fusion protein, while the other three drugs are TNF inhibitors. ...