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Upadacitinib for treating moderate to severe rheumatoid arthritis

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2 Information about upadacitinib

Marketing authorisation indication

2.1 Upadacitinib (Rinvoq, AbbVie) is indicated 'for the treatment of moderate to severe active rheumatoid arthritis in adult patients who have responded inadequately to, or who are intolerant to, one or more disease-modifying antirheumatic drugs (DMARDs).' Upadacitinib may be used as monotherapy or in combination with methotrexate.

Dosage in the marketing authorisation

2.2 The recommended dose is 15 mg once daily orally. Treatment should not be started in patients with an absolute lymphocyte count that is less than 500 cells/mm3, an absolute neutrophil count that is less than 1,000 cells/mm3 or who have haemoglobin (Hb) levels that are less than 8 g/dL. Treatment should be interrupted if a patient develops a serious infection, until the infection is controlled.

Price

2.3 The list price for upadacitinib is £805.56 per 28‑day pack (company submission). The average cost for each patient per year is estimated at £10,508, based on the list price. The company has a commercial arrangement (simple discount patient access scheme). 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.