New research shows arthritis patients still denied treatments in health care lottery

ACCESS TO ANTI-TNF ALPHA THERAPIES FOR ADULTS WITH INFLAMMATORY ARTHRITIS: A Report by the British Society for Rheumatology and the Arthritis & Musculoskeletal Alliance

Doctors have responded with concern following the publication of new research today (June 6 2005) which shows that patients with severe rheumatoid arthritis are still being denied access to vital treatments, despite guidance from the National Institute for Clinical Excellence (NICE) instructing health care trusts to provide them.

The new research was commissioned by the British Society for Rheumatology (BSR) and the Arthritis and Musculoskeletal Alliance (ARMA) after growing concerns from doctors and patients. The research suggests very little has changed since a similar survey in 2003.

Professor David Isenberg, a rheumatologist and President of the BSR, thought the results were ‘very disappointing’. He said:

“It is immensely frustrating for doctors to have patients who clearly qualify for anti-TNFa intervention but are unable to get it. These drugs offer hope and relief to people who have severe rheumatoid arthritis, and are likely to be affected by high levels of pain and disability, making their day to day living very difficult.”

Of the 148 rheumatology units across the UK which responded to the 2005 survey:

• 31% of doctors are unable to provide treatment to all qualifying patients
• More than 50% cited lack of funding as the reason
• Doctors estimate nearly 1700 rheumatoid arthritis patients who could benefit from anti-TNFa drugs are being denied treatment.

Doctors also said they were unable to help people with other arthritis related conditions with anti-TNFa treatments despite the clear benefits of doing so; 58% were unable to prescribe the treatments for people with ankylosing spondylitis (AS), and 53% saying they were unable to prescribe the treatments for people with psoriatic arthritis (PSA). NICE is developing guidance on these treatments, but in the meantime the lack of approval from NICE is the main barrier to treating AS and PSA with these drugs.

A similar survey carried out by ARMA in 2003 showed around 33% of doctors were unable to prescribe anti-TNFa treatments to all qualifying patients with rheumatoid arthritis, showing only a 2% improvement over two years. These results are in spite of the NICE guidance, which was introduced in 2002.

Professor Isenberg added:

“NICE guidance was developed to combat this type of inequality, but it isn’t working for all of our patients. It is wrong that some people are being left with unnecessary pain and disability. The Department of Health should remind health trusts they need to take urgent and immediate action to ensure people get the treatment they are entitled to.”

Ends

For further information, please contact Karishma Chandaria on 020 7242 3313 or kchandaria@rheumatology.org.uk.

Notes to editors:

1. Copies of ‘Access to anti-TNFa treatments for adults with inflammatory arthritis – 2005’ are available from the BSR Website.
2. Doctors unable to prescribe anti-TNFa treatments, and patients unable to gain access to them, are available from Ben Furner.
3. ‘Access to anti-TNFa treatments for adults with inflammatory rheumatoid arthritis – 2005’ was compiled through questionnaires with rheumatologists working in 148 specialist units across the UK, out of a total of 210 which were approached between February and May of 2005.