2 The technology

2.1 Secukinumab (Cosentyx, Novartis) is a high‑affinity, fully human monoclonal antibody that binds to and neutralises interleukin‑17A, which is thought to be involved in the body's autoimmune response in diseases such as psoriasis. Secukinumab has a marketing authorisation for 'the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy'.

2.2 The summary of product characteristics includes the following adverse reactions for secukinumab: upper respiratory tract infections (most frequently nasopharyngitis, rhinitis), oral herpes simplex, rhinorrhoea, diarrhoea and urticaria. For full details of adverse reactions and contraindications, see the summary of product characteristics.

2.3 Secukinumab is given subcutaneously. The recommended dosage is 300 mg at weeks 0, 1, 2 and 3, followed by monthly maintenance dosing starting at week 4. The undiscounted price for 2 × 150 mg prefilled pen or syringe is £1218.78 (excluding VAT, 'Monthly Index of Medical Specialities' [MIMS] May 2015). The company has agreed a patient access scheme with the Department of Health. This scheme provides a simple discount to the list price of secukinumab, with the discount applied at the point of purchase or invoice. The level of the discount is commercial in confidence. The Department of Health considered that this patient access scheme does not constitute an excessive administrative burden on the NHS.