Resource impact statement
No significant resource impact is anticipated
NICE has recommended upadacitinib, alone or with methotrexate, as an option for treating active psoriatic arthritis in adults whose disease has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) or who cannot tolerate them. It is recommended only if they have peripheral arthritis with 3 or more tender joints and 3 or more swollen joints and:
- they have had 2 conventional DMARDs and at least 1 biological DMARD or
- TNF‑alpha inhibitors are contraindicated but would otherwise be considered (as described in NICE's technology appraisal guidance on etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis).
Upadacitinib is recommended only if the company provides it according to the commercial arrangement. Further criteria can be found in the guidance.
These recommendations are not intended to affect treatment with upadacitinib that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.
We do not expect this guidance to have a significant impact on resources; that is, the resource impact of implementing the recommendations in England will be less than £5 million per year (or £9,000 per 100,000 population, based on a population for England of 56.3 million people).
This is because the technology is a further treatment option and is available at a similar price to the current treatment options.
Upadacitinib has a commercial arrangement. This makes upadacitinib available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company’s responsibility to let relevant NHS organisations know details of the discount.
A resource impact template is provided for completion at a local level. This is because there are numerous treatment options that are recommended by NICE for treating active psoriatic arthritis.
Upadacitinib is commissioned by integrated care systems/clinical commissioning groups. Providers are NHS hospital trusts.
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