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NICE guidelines on anti-tumor necrosis factor therapy for RA

Nature Clinical Practice Rheumatology volume 5, pages 16–17 (2009)Cite this article

The UK National Institute for Health and Clinical Excellence (NICE) utilizes the available evidence to provide guidance on the efficacy and cost-effectiveness of existing health technologies. NICE advisors decide that a technology is of value to society when its cost falls beneath a certain threshold—conventionally under £30,000 (approximately $50,000) per quality-adjusted life year. NICE can work only with the available evidence. In many cases, this evidence is neither good nor complete, but the quality of the evidence is not something that NICE can influence directly. Its proponents believe that NICE is far more than a system for rationing expensive treatments.1 Its critics, however, argue that rationing is its central business, and that NICE often deprives patients from receiving the effective treatments they wish to have.2

In the field of rheumatology, NICE has focused mainly on treatment with biologic agents—the tumor necrosis factor (TNF) inhibitors, human interleukin-1 receptor antagonists, anti-B-cell antibodies and CD4+ T-cell costimulation modulators. NICE has previously recommended the use of anti-TNF agents to treat rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis, as well as rituximab for RA. It has not approved anakinra or abatacept for RA therapy on the basis of cost-effectiveness analyses.

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Authors and Affiliations

  1. DL Scott is Professor of Clinical Rheumatology and Honorary Consultant Rheumatologist, and S Steer is a recently appointed Consultant Rheumatologist at King's College Hospital, London, UK.,

    David L Scott & Sophia Steer

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  1. David L Scott
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  2. Sophia Steer
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Correspondence to David L Scott.

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The authors declare no competing financial interests.

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Scott, D., Steer, S. NICE guidelines on anti-tumor necrosis factor therapy for RA. Nat Rev Rheumatol 5, 16–17 (2009). https://doi.org/10.1038/ncprheum0964

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