Cimzia (certolizumab pegol) was approved in Europe in the new indication of plaque psoriasis earlier this year, adding to a list of uses including rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis.

While there are a number of other anti-TNF drugs approved in psoriasis, including AbbVie’s Humira and biosimilars, Cimzia is the first in the class that can be taken by women during pregnancy and lactation.

Meanwhile Almirall’s Ilumetri (tildrakizumab) was approved in Europe in September as a subcutaneous injection offering a patient-friendly quarterly dosing schedule, as opposed to fortnightly and sometimes monthly dosing for Cimzia injections.

In its draft guidance NICE said Cimzia, which costs around £6,793 per patient, is cost-effective and can be used when patients have not responded to other systemic therapies such as phototherapy, methotrexate and cyclosporine, or if these treatments are not suitable.

Around 17,000-28,000 people will be eligible for the treatment, and NICE said the drug has similar cost-effectiveness to other biologic treatments.

NICE noted clinical trial evidence showing Cimzia outperformed placebo and the well established biologic from Pfizer, Enbrel (etanercept), in severe psoriasis.

However NICE said in draft guidance that Ilumetri was not cost-effective, and noted the rival therapies that have already been approved in the indication.

These include Leo Pharma’s Kyntheum (brodalumab), Janssen’s Tremfya (guselkumab), AbbVie’s Humira (adalimumab), Eli Lilly’s Taltz (ixekizumab), and Novartis’ Cosentyx (secukinumab).

As this is first draft guidance, Almirall still has scope to drop its price ahead of publication of a second draft in the coming months.

Around 102,000 to 172,000 adults are affected by psoriasis, where an overactive immune system leads to thickened, red scaly plaques on the skin.

The drugs counter the disease by turning down the activity of the immune system.[:]

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