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Baricitinib for Previously Treated Moderate or Severe Rheumatoid Arthritis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal

Ren S, Bermejo I, Simpson E, Wong R, Scott DL, Young A, Stevenson M. - Pharmacoeconomics 2018 Jul; 36(7):769–78

In this National Institute for Health and Care (NICE) single technology appraisal of baricitinib (BARI) monotherapy and combination therapy with methotrexate (MTX), BARI efficacy was considered comparable to bDMARDs and a cost-effective use of National Health Service (NHS) resources.

NICE is an independent organisation responsible for providing national guidance on health technologies in England. To be recommended by NICE, the company must provide evidence to prove BARI’s effectiveness, both clinically and costly. This evidence based review, reported the analysis of the evidence review group (ERG) for the single technology appraisal of BARI.

In the analysis, the ERG concluded that the clinical evidence and eligibility criteria were considered adequate and reasonable by the ERG. However, the ERG highlighted that the results presented should be treated with caution due to problems with the study methods.

BARI was considered cost-effective in most populations, except the TNFi inadequate response population where BARI was dominated by rituximab (RTX); for this population that could not receive RTX, BARI dominated its comparators.
To conclude, BARI monotherapy and combination therapy with MTX were found to have comparable efficacy for treating moderate to severe RA as other bDMARDs recommended by NICE. In June 2017, NICE approved BARI as monotherapy and combination therapy for patients with active RA, who had responded inadequately to intensive therapy with cDMARDs and other DMARDs, including ≥1 bDMARD.