To ask the Secretary of State for Health if he will instruct the National Institute for Health and Clinical Excellence to take account of the effects on society and on public expenditure when evaluating treatments of rheumatoid arthritis which enable patients to continue to work or to return to work. (247296)

The process by which the National Institute for Health and Clinical Excellence (NICE) appraises drugs and treatments is a matter for the institute. NICE undertakes a wide consultation, on a regular basis, on the methods and processes in follows in health technology appraisal. The latest guidance to its methodologies was published on 23 June 2008 and details can be found on NICE’s website at:

www.nice.org.uk

The methodology guidance NICE uses takes account of the impact of treatments on publicly-funded social care costs and, where relevant, can look at health-related benefits to carers. NICE can also conduct sensitivity analyses to expose potentially significant impacts on other areas of public spending.

To ask the Secretary of State for Health what estimate he has made of the proportion of rheumatoid arthritis patients who fulfil the National Institute for Health and Clinical Excellence requirements for anti-TNF treatment but who do not receive anti-TNF treatment. (247297)

We have made no estimate of the number of people with rheumatoid arthritis meeting the National Institute for Clinical Excellence guidelines who are not receiving anti-TNF treatment.