Rheumatoid Arthritis Patients Face Unofficial Postcode Lottery

People suffering from the debilitating pain of rheumatoid arthritis (RA) face a postcode lottery over whether they can have access to a treatment that is known to improve their condition significantly.

New research published in the medical journal Rheumatology [1] today (11 October 2006) reveals that, despite the National Institute for Health and Clinical Excellence (NICE) approving anti-tumour necrosis factor alpha (TNF) therapy for RA in 2002, many primary care trusts are refusing to fund it adequately or are putting a cap on the numbers of patients that can be treated.

The picture is even worse for the use of anti-TNF therapy in other arthritic conditions such as psoriatic arthritis (PsA) and ankylosing spondylitis (AS) where NICE approval has only just been given or is being awaited.

As a result of these findings, rheumatologists are calling on the Government and primary care trusts to end the unofficial postcode lottery and ensure that every patient who meets the NICE criteria can receive anti-TNF therapy if their consultants consider it appropriate.

Dr Lesley Kay, a member of the British Society for Rheumatology Biologics Register (BSRBR) management committee and co-author of the research, said: "The BSRBR urges the Government and primary care trusts to put an end to this patently unfair situation, which is in direct contravention of government policy. The postcode lottery continues to operate, even though NICE aims to stop this happening. It's unfair on patients with these devastating, painful and unglamorous conditions to be forced to take a low priority and to be deprived of this very successful treatment".

Randomised clinical trials have shown anti-TNF therapy is highly effective in the treatment of RA, juvenile idiopathic arthritis (JIA), PsA and AS. Not only can it arrest the progress of the disease, preventing deformity, but also patients report considerable improvements in symptoms such as joint pain, swelling, mobility and fatigue, and often say that the treatment has made them feel well in themselves for the first time in many years. [2].

However, when Dr Kay and Dr Ian Griffiths sent questionnaires on behalf of the BSRBR (which monitors the use of anti-TNF therapy) to 509 consultant rheumatologists in the UK, the responses on behalf of 252 consultants revealed a wide disparity in the provision of anti-TNF therapy across the country.

Dr Kay, a consultant rheumatologist at the Freeman Hospital and Newcastle University, Newcastle upon Tyne, UK, said: "Nearly half of the consultants (46%) indicated that they had some form of limitation in their prescribing of anti-TNF.

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Posted by: Sean    Source