Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

International guidelines on access to biologic therapy: why the differences and which is best?

Nature Clinical Practice Rheumatology volume 4, pages 520–521 (2008)Cite this article

Biologic therapies have had a profound effect on the treatment of patients with inflammatory arthritis; however, their cost has elevated rheumatology from an often ignored discipline into one that demands the attention of health economy fund holders and policy makers. Guidelines try to ensure appropriate access to biologic therapies but vary considerably between different nations; for example, in some parts of the western world, patients are denied access to therapies that would be available in other countries (sometimes geographic neighbors). Why are there such marked differences in the guidelines for availability of such agents, what can we learn from these discrepancies, and which guidelines are best?

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

References

  1. National Institute for Health and Clinical Excellence (online 24 October 2007) Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis. [http://www.nice.org.uk/guidance/index.jsp?action=download&o=37914]

  2. Fautrel B et al. (2007) Recommendations of the French Society for Rheumatology regarding TNFalpha antagonist therapy in patients with rheumatoid arthritis. Joint Bone Spine 74: 627–637

    Article  CAS  Google Scholar 

  3. Hjardem E et al. (2005) Prescription practice of biological drugs in rheumatoid arthritis during the first 3 years of post-marketing use in Denmark and Norway: criteria are becoming less stringent. Ann Rheum Dis 64: 1220–1223

    Article  CAS  Google Scholar 

  4. Sokka T et al. (2007) QUEST-RA: quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries. Ann Rheum Dis 66: 1491–1496

    Article  Google Scholar 

  5. National Institute for Health and Clinical Excellence (online April 2008) Abatacept for the treatment of rheumatoid arthritis. [http://www.nice.org.uk/nicemedia/pdf/TA141guidance.pdf]

  6. Bansbeck NJ et al. (2005) The NICE re-appraisal of biologics in 2005: what rheumatologists need to know. Rheumatology 44: 3–4

    Article  Google Scholar 

  7. World Health Organization (online 17 September 2003) Technology appraisal programme of the National Institute of Clinical Excellence: a review by WHO. [http://www.nice.org.uk/aboutnice/whoweare/board/boardmeetings/2003/ 17thseptember2003/item_tabled__world_health_organisation_report.jsp]

  8. Ikeda K et al. (2007) Aspects of early arthritis: biological therapy in early arthritis–overtreatment or the way to go? Arthritis Res Ther 9: 211

    Article  Google Scholar 

  9. Wolfe F et al. (2005) The Disease Activity Score is not suitable as a sole criterion for initiation and evaluation of anti-tumor necrosis factor therapy in the clinic. Arthritis Rheum 12: 3873–3879

    Article  Google Scholar 

  10. Deighton CM et al. (2006) Updating the BSR guidelines for anti-TNF therapy in adult RA (again). Rheumatology 45: 649–652

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. C Deighton is a Consultant Rheumatologist and Special Lecturer at the Derbyshire Royal Infirmary, Derby, UK.,

    Chris Deighton

  2. K Hyrich is a Senior Lecturer in Rheumatic Disease Epidemiology at the ARC Epidemiology Unit, University of Manchester and a Consultant Rheumatologist at the Manchester Royal Infirmary, Manchester, UK.,

    Kimme Hyrich

Authors
  1. Chris Deighton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kimme Hyrich
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chris Deighton.

Ethics declarations

Competing interests

C Deighton works at the Department of Rheumatology at Derbyshire Royal Infirmary, which has received sponsorship from Abbott, Schering–Plough Pharmaceuticals and Wyeth for support of clinical meetings, and unrestricted grants from Schering–Plough and Wyeth to support an anti-tumor necrosis factor audit clerk and research nurse. C Deighton has also previously sat on an advisory board for Schering–Plough and received honoraria for talks at symposia sponsored by Abbott and Wyeth. K Hyrich declared no competing interests.

Supplementary information

Supplementary information

Examples of international guidelines on the use of anti-tumor necrosis factor therapy in patients with rheumatoid arthritis. (DOC 32 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Deighton, C., Hyrich, K. International guidelines on access to biologic therapy: why the differences and which is best?. Nat Rev Rheumatol 4, 520–521 (2008). https://doi.org/10.1038/ncprheum0877

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncprheum0877

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing