England rejects Stelara for psoriatic arthritis

[Fred]

Following on from the European Commission, USA, Canada, and Scotland. England have decided Stelara will not be used for psoriatic arthritis. It works and I'm living proof of that, Boo Hiss to you England.

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Quote:

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Final draft guidance, from the National Institute for Health and Care Excellence, published today does not recommend ustekinumab (Stelara) for psoriatic arthritis.


Ustekinumab (Stelara) is not recommended within its marketing authorisation for treating active psoriatic arthritis, that is, alone or in combination with methotrexate in adults when the response to previous non-biological disease-modifying antirheumatic drug (DMARD) therapy has been inadequate.
   
People currently receiving treatment initiated within the NHS with ustekinumab that is not recommended for them by NICE in this guidance should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

The Committee concluded that ustekinumab is not a cost-effective treatment option for people who have not previously received TNF alpha inhibitors, for those cannot take them, or for those who have received TNF alpha inhibitors. In the economic analysis for people who have not previously received TNF alpha inhibitors (the ‘TNF alpha inhibitor-naive' population), ustekinumab was dominated by - that is, was more expensive and less effective than - adalimumab. In all other populations, including people who have previously received TNF alpha inhibitors (the ‘TNF alpha inhibitor-exposed' population) and people for whom TNF alpha inhibitors are not appropriate, the most plausible incremental cost-effectiveness ratio (ICER) for ustekinumab is likely to exceed £30,000 per quality-adjusted life year (QALY) gained.

Come on England the rest agree it works, and what about people like me where nothing else worked.

[jiml]

Sorry Fred I am a bit dim and don't understand why.
Is it purely on cost they are stopping or is the alternative adalimumad, a direct replacement only cheaper?

[Fred]

Sorry Fred I am a bit dim and don't understand why.
Is it purely on cost they are stopping or is the alternative adalimumad, a direct replacement only cheaper?

Well the way I have understood it's mainly due to cost, they are not stopping the use of Stelara but they are saying it's not cost effective in the treatment of Psoriatic Arthritis.

In their opinion it's not as affective or as cost effective as Adalimumab (Humira), which in my opinion and the rest of the world it seems is absolute rubbish.

I have tried them all and can't use Humira due to a reaction from it, so where that would leave me in England I guess would be back to immobile and full of flakes heading for Scotland, Europe, USA, or Canada.

So yes it's costs.

[Paul9]

Sorry Fred I am a bit dim and don't understand why.
Is it purely on cost they are stopping or is the alternative adalimumad, a direct replacement only cheaper?

Well the way I have understood it's mainly due to cost, they are not stopping the use of Stelara but they are saying it's not cost effective in the treatment of Psoriatic Arthritis.

In their opinion it's not as affective or as cost effective as Adalimumab (Humira), which in my opinion and the rest of the world it seems is absolute rubbish.

I have tried them all and can't use Humira due to a reaction from it, so where that would leave me in England I guess would be back to immobile and full of flakes heading for Scotland, Europe, USA, or Canada.

So yes it's costs.

It always seems to come down to cost in financial terms, rather than cost in quality of life.

[jiml]

Yes Paul it's a shame but a sad fact of life, that it all comes down to the money.
At £30,000 per year if that's the cost, is in my mind obscene someone is making fat profits as usual whilst patients suffer.
I know drug companies need profit to fund research but not all the profit goes to research.
It's the same in every branch of medicine. The drug companies patent their product then charge extreme prices.

[Caroline]

Indeed very shameful to have the health of people dominated by the costs of this treatment.
As so often the money prevails.
Boo.

[mataribot]

There really isn't a cheap solution for PsA. None of the traditional DMARDs are true modification therapy for PsA. The only that hasn't been studied is cyclosporin - but that is not a safe long term treatment. If they really want a cheap solution for PsA, then why don't they spend the money and develop their own drug.

[Caroline]

There really isn't a cheap solution for PsA. None of the traditional DMARDs are true modification therapy for PsA. The only that hasn't been studied is cyclosporin - but that is not a safe long term treatment. If they really want a cheap solution for PsA, then why don't they spend the money and develop their own drug.

O but there is Mataribot. Jim and I are using that one.

Still bless the ISM that I found this treatment.