Sarilumab for moderate to severe rheumatoid arthritis

Sarilumab (Kevzara, Sanofi) has a marketing authorisation in the UK for the 'treatment of moderately to severely active rheumatoid arthritis in adult patients who have responded inadequately to, or who are intolerant to one or more disease-modifying antirheumatic drugs.' Sarilumab can be given as monotherapy or in combination with methotrexate.

The recommended dose of sarilumab is 200 mg administered once every 2 weeks. A reduction in dose from 200 mg once every 2 weeks to 150 mg once every 2 weeks is recommended for management of neutropenia, thrombocytopenia and liver enzyme elevations. Sarilumab is administered subcutaneously using a pre-filled pen or syringe. See the summary of product characteristics for details.

The list price per pre-filled pen or syringe of 150 mg or 200 mg of sarilumab is £456.13.

The average cost per patient per year is estimated at £11,900 based on the list price.

The company has agreed a patient access scheme with the Department of Health. This scheme provides a simple discount to the list price of sarilumab, 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.