An expensive wonder drug used to battle the most severe cases of rheumatoid arthritis could soon treat NHS patients with a range of diseases after cut-price versions became available.
Adalimumab, known by the brand name Humira, dampens the inflammation that causes the joint pain and swelling of rheumatoid arthritis.
But it can also treat other serious inflammatory disorders, such as bowel diseases Crohn’s and ulcerative colitis, skin condition psoriasis and the painful inflammation of the spine called ankylosing spondylitis.
These illnesses, all of which are triggered by faults in the immune system, affect millions of Britons.
However, at £10,000 a year for each patient, adalimumab was one of the most expensive drugs ever prescribed on the NHS, meaning it was given mainly to those with severe disease who did not respond to older, cheaper drugs.
But now, alternative versions of adalimumab that are up to 75 per cent cheaper – and no less effective – are on the market.
Adalimumab, known by the brand name Humira, dampens the inflammation that causes the joint pain and swelling of rheumatoid arthritis. Pictured: Stock image
The National Institute for Health and Care Excellence (NICE), which vets NHS drug spending in England, is considering extending their use for less severe rheumatoid arthritis – a review which, it is hoped, could pave the way for wider use in the other disorders too.
Adalimumab is a type of drug known as biologics. While conventional drugs are manufactured by mixing chemicals in a lab, biologics are made using living organisms, such as bacteria, yeast and even animal tissue and cells.
This makes them costly to develop, which is why drug makers patent their creations and sell them at a high price.
Drug patents usually last about 20 years, after which they expire and other companies are free to create their own versions, which eventually drives prices down.
Pharmaceutical giant AbbVie launched Humira in 2002, and its patent expired in 2018. Several companies have since been granted licences to produce versions of the drug, known as biosimilars.
The move is part of a wider NHS cost-cutting drive to prescribe cheaper copies of drugs as soon as they become available.
‘The cost to the NHS is tumbling and the savings have been fantastic,’ says Paul Fleming, technical director of the British Biosimilars Association, a body representing firms making the cheaper drugs. ‘And there are many more of these drugs in the pipeline that could be life-changing for people.’
Crohn’s disease sufferer Serena James, 26, from London, is due to be switched from Humira to a cheaper version in the next few months. She was diagnosed with Crohn’s at 15, after two years of tests.
‘When I was 13 I started to get really painful ulcers in my mouth and throat,’ says Serena, an undergraduate adviser at the London School of Economics.
Doctors were baffled as mouth ulcers are a rare symptom of Crohn’s disease – most cases involve severe diarrhoea, stomach cramps, exhaustion and weight loss.
Serena says: ‘It wasn’t until I was 15 that I finally found out it was Crohn’s. The ulcers were so bad I had to spray my mouth and throat with local anaesthetic before I could even try to chew or swallow food.’
She then developed other symptoms, including extreme fatigue. She adds: ‘I’d be fine one minute and not able to leave the house the next. Sometimes I was so weak I couldn’t even get dressed.’
In her early 20s, Serena was given Humira – but only after local health chiefs had sanctioned the £10,000 a year it would cost.
‘After a few months I really started to notice a big improvement,’ she says. ‘It really gave me my life back, and I’m slightly nervous about taking a different drug but hopefully it will be OK.’
The British Biosimilars Association says there are at least 20 more biosimilars coming in the next five to ten years.
One is a copy of Lucentis, a treatment for age-related macular degeneration, a leading cause of blindness that affects 600,000 people in the UK, which is expected to halve the NHS’s current £250 million annual bill.