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    Has all of the relevant evidence been taken into account?

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    Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?

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    Are the recommendations sound and a suitable basis for guidance to the NHS?

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1 Recommendations

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2 Partial review of NICE technology appraisal 375

2.1 This multiple technology appraisal is a partial review of NICE technology appraisal 375 which recommended adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept (all in combination with methotrexate) as treatment options for people with severe rheumatoid arthritis only, assessed by having a disease activity score (DAS28) more than 5.1. This partial review considers people with moderate active disease, that is, with a DAS28 score between 3.2 and 5.1. Although certolizumab pegol, golimumab and tocilizumab were included in the original guidance, the manufacturers of these technologies decided not to participate in this partial review. So, the committee could only consider adalimumab, etanercept, infliximab and abatacept when making recommendations for people with moderate active disease. A partial review has been done because biosimilar versions of adalimumab and etanercept are now available, and there have been changes in the prices for some of the other technologies.