Does anyone know what the lowest cost (list price) biologic is in the UK? I moved here from the US 2 years ago, and had been on Humira for a long time there. Humira (adalimumab) worked brilliantly. I haven't been able to get that here so I have been on Methotrexate for 6 months and it has only gotten worse. My dermatologist is impossible to get a hold of and the GP won't do anything so I really just don't want to deal with the NHS anymore and will just go private and pay for a biologic. So, does anyone know which biologic is most affordable?
Posted Thu 29 Apr 2021 20.00 by lizziep
Sorry - the NHS has always provided my medications.
The cost of biologics rises with efficacy. The better the meds, the higher the cost.
Methotrexate is low efficacy, so low cost.
Adalimumab is medium efficacy, so medium cost.
Risankizumab is high efficacy, so high cost.
The NHS / NICE publish UK biologic costs online.
A quick Google today suggests adalimumab (Humira) to be cheapish, at a trade price of £150-750 per shot in 2021.
Etanercept (Enbrel) is £80-200 a shot in 2021 (but less effective).
Risankizumab (Skyrizi) trades around £1-4k per shot in 2021.
Might be worth trying a new GP and derm. NHS quality (and budget) varies wildly by zip code. Get a second opinion. It may still be possible to get Humira for "free" on the NHS.
looking at the costs of Humira i would think it is highly unlikely to be provided on the NHS , I have had psoriasis over 30 years and some of the new medications which are prescribed in other countries may not be available on NHS here (due to testing and above all cost )and our NHS guidelines for the drugs state its se as being for Crohns Disease or Rhuematoid arthritis .I have ben trying to get a referral for a dermatologist for the last 7 years and have only managed to get an appointment with a trainee ! which was no better than the GP . I suggest you see a Private dermatologist ( you can get a list for your area) at least when you get the consultation he will advise of available medications for you to buy
Posted Fri 30 Apr 2021 08.40 by lizziep
I have no trouble at all seeing a dermatologist in my area and have been 'under' the local hospital for 50 years.. I was also prescribed Fumaderm before it was approved by NICE in this countryand was approved in Germany as they believed it to be the best drug for me.
Posted Fri 30 Apr 2021 09.05 by plantlady1985 (edited Fri 30 Apr 2021 09.06 by plantlady1985)
We live in London, so perhaps that has something to do with it (low gp/specialist availability for the population). It took about 5 months from the time we moved here to even get an appointment with a GP for a referral and a whole year from that to see a dermatologist. Before the pandemic hit I was just flying back to the US to pick up Humira as I still had US health insurance. Unfortunately I no longer have US health insurance otherwise I would have kept doing that!
Posted Fri 30 Apr 2021 09.07 by lizziep (edited Fri 30 Apr 2021 09.07 by lizziep)
Try going private and getting yourself referred by him/her back to his/her NHS practice.
By the way, I do work in Pharma R&D. Biologics are more expensive not just because of efficacy/uniqueness but because of the difficulty and time for research, development and especially manufacturing. Making biologics at scale is a very finicky and expensive process, thus the high prices.
Posted Fri 30 Apr 2021 20.18 by Yacht
Humira is available on the NHS. It is listed online by NICE as a "first line" treatment, if methotrexate does not work.
Posted Sat 1 May 2021 19.39 by Yacht
Be mindul that etanercept has only a 20% chance of 90% clearance for psoriasis (PASI 90).
It is almost as low as methotrexate (9%).
Adalimumab is around 45% chance.
Something like risankizumab is (currently) among the best, at 75% chance.
All stats freely available on the Web.
1Posted Mon 3 May 2021 09.16 by Steview A P sufferer for over 30 years, through good and bad times.
My first question is as are you American or UK citizen? Plus are you entitled to full NHS treatment free of charge at point of need or do you require some other form of medical insurance?
As previously stated Humira or its biosimilar are available on the NHS but NICE guidelines should be followed.
If you cannot get a refferal to a dermatologist I would agree with the suggestion to get a private consultation and see what they recommend.
List prices of the various biologic drugs is not always the same as what the NHS may pay as they will have agreements in place. What I understand with American insurance that cover biologic treatment is that the drug companies often charge the insurance companies more for their drugs, a little like having a car repaired through insurance rather than paying yourself.
Good luck.
Posted Mon 3 May 2021 09.35 by plantlady1985
US citizen... here on a 5 year Tier 2 visa. I have full NHS coverage and private insurance through my employer but they do not cover chronic conditions.
I have been referred through a dermatologist through the NHS however it’s my understanding that they have a checklist to go through before they would prescribe a biologic. Start with a low dose of methotrexate then increase to injections.... I don’t see the point in damaging my liver when I know that Humira works very well for me. Hence the reason why I’d rather just pay out of pocket for Humira or its biosimilar if I can. I saw a private derm about a year ago but he seemed to not know anything about biologics, how to get them, or how much they cost which is why I’m trying to do research on my own.
I had very good private health insurance in the US, paid around 30 USD per month for Humira.
Posted Mon 3 May 2021 09.56 by Steview A P sufferer for over 30 years, through good and bad times.
Plantlady, yes you are correct we have to go through all the hoops under the NHS.
Most peeps in the UK wouldn't purchase biologics privately due to the cost. I am not sure where you purchase the drug from privately, maybe contact the pharmaceutical company. Even if you can then as you know you will require regular blood tests and I would imagine they will be at your expense as you are covering the costs of biologics.
I note you say your previous private consultation knew little about biologics but if you found a good private consultant you may have to continue treatment through them to monitor your bloods.
As you have been on Mtx for a while and it is failing well that is one step already taken, maybe try another oral then you may be on the road to biologics under the NHS. Have you had phototherapy?
Posted Tue 4 May 2021 01.18 by Yacht
The NHS usually starts with the cheapest treatment (for psoriasis), and then works up the scale.
UK docs like methotrexate because it is cheap and easy, at around 10-50p per oral tablet.
Methotrexate is basically chemotherapy (for cancer), and its effectiveness for psoriasis clearance is low. Studies suggest under 10% chance of 90% clearance.
Posted Tue 25 May 2021 19.31 by Becca’s mum
There was an article in the health section of the Guardian recently, which was saying that Humira was launched in 2002 at a cost of £10,000 a year per patient. Because it’s coming up for 10 years, it can now be manufactured by other pharmaceutical companies and this will force a price drop, which will make it more available on the NHS. The British Biosimilars Association is looking at cheaper but equally effective alternatives, to get on the NHS.
I know this doesn’t help you right now, but it’s good news and hopefully will be available from next year.
Posted Wed 23 Jun 2021 19.31 by V62
If you want to get a Humira privately and live in London I noticed that Guys hospital has a private dermatology department. If you contact them then am sure you will be able to get what you want. I think it costs around £10,000 annually to buy it.
Posted Tue 6 Jul 2021 05.02 by Angry
I have had inverse psoriasis for the last 5 month creams are not working, can someone tell me what I should do next try light therapy or go on to biologicals.
Posted Thu 29 Apr 2021 19.59 by plantlady1985
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Posted Fri 30 Apr 2021 05.48 by scarletsmummy