Rheumoid arthritis sufferers in England and Wales may be banned from using a powerful drug approved for NHS use in Scotland.

Toclizumab targets interleukin-6, an inflammatory signalling molecule, to reduce painful symptoms and has been found to reduce remission rates six-fold when combined with methotrexate, a standard anti-inflammatory.

National Institute for Health and Clinical Excellence (Nice), which assesses the cost effectiveness of treatments in England and Wales, provisionally said the £9,000 per patient per year drug was too expensive for the NHS, but the body's Scottish equivalent took a different view.

Scottish Medicine Consortium (SMC) guidance said patients north of the border should get the treatment, marketed as RoActemra, for free in combination with MTX for moderate to severe rheumatoid arthritis if other options do not work.

NHS funding bodies do not feel obliged to pay for tocilizumab, but Nice has indicated it may change its final guidance if the drug's manufacturer, Roche, can prove it really is cost effective.

Most European sufferers of rheumatoid arthritis who do not respond to other therapies already have access to the drug.

Copyright © Press Association 2010

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