Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed (partial review of TA375): Final appraisal document
NICE has previously recommended biological treatments only for severe disease. This guidance was reviewed because less costly biosimilars have since become available. Clinical evidence suggests these treatments are likely to be similarly effective in both moderate &severe disease
Source:
National Institute for Health and Care Excellence
SPS commentary:
According to DRAFT updated guidance, the most likely estimates suggest that adalimumab, etanercept and infliximab after 2 or more conventional DMARDs are a cost-effective use of NHS resources, so they are recommended for treating moderate rheumatoid arthritis, providing certain criteria are fulfilled. However, the most likely cost-effectiveness estimates for abatacept are higher than what NICE normally considers cost effective, so it is not recommended for moderate disease.