(2) what assessment he has made of the (a) scheduling and (b) timescale of the reappraisal process undertaken by the National Institute for Health and Clinical Excellence in respect of the sequential use of anti-TNF drugs for rheumatoid arthritis; and what representations he has received on this matter.
The National Institute for Health and Clinical Excellence (NICE) issued its current technology appraisal guidance to the NHS on the initial use of adalimumab, infliximab and etanercept for the treatment of rheumatoid arthritis in October 2007, which is 40 months from the date that Ministers referred adalimumab for the treatment of rheumatoid arthritis to NICE's technology appraisal work programme. The guidance partially updated NICE's existing guidance on etanercept and infliximab for rheumatoid arthritis.
NICE is currently developing separate appraisal guidance on the use of adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor (TNF) inhibitor. NICE currently expects to publish updated guidance on this topic in July 2010. Until NICE publishes final guidance for this appraisal, NICE'S existing guidance on the use of etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of an anti-TNF in technology appraisals TA36, TA126 and TA141 remains in place.
The scheduling of work on specific technology appraisal reviews is a matter for NICE, but we understand that in this case the guidance development process has been particularly complex because of the need to address issues identified at the appeal stage.
Between April and December 2008, the Department of Health has received 135 pieces of correspondence relating to NICE and the use of TNF inhibitors.