NICE finally approves Stelara for psoriatic arthritis

[Fred]

Following on from the report last December that there could soon be a deal done with the National Institute for Health and Care Excellence (NICE) and the use of Stelara for the treatment of psoriatic arthritis, finally it's been worked out and Stelara will now be available. There is a catch however: It won't be used as a first line bio and you will have to wait till you have tried the others first.

Quote:

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Janssen's Stelara has been recommended by NICE as a treatment option for patients with active psoriatic arthritis a year after the Institute was minded to reject the treatment.

In final guidance, Stelara (ustekinumab) is now recommended either alone, or in combination with methotrexate, as a second-line therapy.

It is specifically for patients whose response to previous non-biological disease modifying anti-rheumatic drug (DMARD) therapy has been inadequate.

It is also recommended for patients who have had treatment with one of more TNF-alpha inhibitors, such as Janssen's own Simponi (golimumab) and Remicade (infliximab), as well as AbbVie's Humira (adalimumab) and Pfizer's Enbrel (etanercept).

NICE last year said it would not recommend the drug as it was too costly, but a patient access - which cuts the price of the medicine - has since been offered by the firm, helping it get onto the NHS's funding stream.

The recommendation also limits the drug to be used after other have been tried, meaning its sales potential in England will be knocked as it will not be funded as a first-line therapy.

Peter Barnes, medical director at Janssen UK, said of the decision: “We are delighted with today's recommendation from NICE. We know that people living with psoriatic arthritis are in real need of additional treatment choices that can help them manage a debilitating and often painful condition.

“Ustekinumab could have a marked positive impact of the quality of life for many of these patients living with active psoriatic arthritis and represents an important additional treatment option for this condition.”

The list price for the treatment is £2,147 per 45mg vial, and NICE estimates that the average annual cost for a 45mg and a 90mg dose are £10,735 and £21,470 in the first year, and £9,304 and £18,608 per year thereafter respectively.

Source: pmlive.com

UK could get Stelara discount for psoriatic arthritis.

[jiml]

Wooooow..... I think that's good news .... No it is great news. It's something we have been waiting to get approval in the UK..... But it seems to me that the approval seems to be more based on price than need..or efficacy..
We have known of the efficacy of Stelara from our members accounts of their use of it.

So the reason I say I think it's good news is because sufferers are going to have to suffer longer and fail on other treatments before being considered for it.

It's a step in the right direction though, at least it is a tool for rheumatologists to consider

[Caroline]

Certainly a step in the right direction.
good it will at least be available.

[Bill]

I have heard it said that if patients were prescribed out of patent medicines that had equal or better efficacy than the patented drugs, medicines would be 95% cheaper. With such savings it might be possible to supply the best therapy first instead of second rate ones. The mark up on DMF is over 100 times and the pharmaceutical formulations are no better in my opinion, and perhaps even less so than the raw stuff. The proportion of psoriasis sufferers unresponsive to the cheaper therapies cannot be very great. It would be nice to see people properly treated instead of stuffed around by an inefficient allocation of funds.

Cheers,

Bill

[Gilly]

I always feel a little queasy thinking about drugs which play with your immune system, but since I went to war on my own psoriasis I'd probably try anything.... and I'd just be happy being able to see a decent skin specialist, whose knowledge of what's available was reliable; sooner rather than later. I've been mucked around for 3 years, this month I finally get to see a specialist after waiting for 5 months and all he does is answer texts while I'm grizzling and moaning and then prescribes me something which I find out I can't take because of other medication, after I pay out $40 for it and get to read the information leaflet.  I prob don't know what I'm talking about but I've given it a shot  

[jiml]

I always feel a little queasy thinking about drugs which play with your immune system, but since I went to war on my own psoriasis I'd probably try anything.... and I'd just be happy being able to see a decent skin specialist, whose knowledge of what's available was reliable; sooner rather than later. I've been mucked around for 3 years, this month I finally get to see a specialist after waiting for 5 months and all he does is answer texts while I'm grizzling and moaning and then prescribes me something which I find out I can't take because of other medication, after I pay out $40 for it and get to read the information leaflet.  I prob don't know what I'm talking about but I've given it a shot  

Gilly it's quite clear what you are writing about. You should fear the disease more than the drug, the drugs are all tested and although there are side effects, as long as you are monitored closely like with Stelara you really have more to gain than lose, if you get the chance to go on a biological like Stelara, don't fear it. Because the chances are it may give you clearance and a better quality of life
I don't know anything about the Australian health system and what your dermatologists are like. But I'm sure if you saw a good one he could reassure you ........
Jim

[Gilly]

Hi Jim, prob a good thing you don't know much about our health system, it's a waiting game, months and months of waiting...and here I am again on the roundabout waiting again, but still, it could be worse and I have no right to whine, I have a friend who is in hospital about to have a lung out in the morning.  I have the best job in the world! I love it

[jiml]

Hi Jim, prob a good thing you don't know much about our health system, it's a waiting game, months and months of waiting...and here I am again on the roundabout waiting again, but still, it could be worse and I have no right to whine, I have a friend who is in hospital about to have a lung out in the morning.  I have the best job in the world! I love it

Having a job you are happy in and a life without to much stress, almost... Makes up for your healthcare system ..
Sorry to hear about your friend I hope for a good outcome for her ..
Btw I think we should take this conversation elsewhere on the forum as we are going rather off topic so I will move this conversation here if you don't mind [Group Specific] and we can continue there or start somewhere else if you prefer

[Paul9]

Hi, I am pleased at this, because i am currently on Enbrel and Mtx (both injected). I am not reacting well to the recent re-introduction of the Mtx, and think that I will have to come off it again soon.

I am not convinced that the Enbrel is working well, and understand that in most cases, even after a good start, benefits of Enbrel reduce after 1-2 years.

Now that Stelara is an option, it opens up the choice, and so may be the next logical step in my bio treatments.

[jiml]

Hi, I am pleased at this, because i am currently on Enbrel and Mtx (both injected). I am not reacting well to the recent re-introduction of the Mtx, and think that I will have to come off it again soon.

I am not convinced that the Enbrel is working well, and understand that in most cases, even after a good start, benefits of Enbrel reduce after 1-2 years.

Now that Stelara is an option, it opens up the choice, and so may be the next logical step in my bio treatments.

Let's hope you get offered it Paul, it's something to mention to the rheumatologist at the next appointment. And hopefully you will get it,
Good luck