10.1.3 Immunosuppressants

Click Here for Kent and Medway Health Economy National Tariff Excluded Drugs Manual -High Cost Drugs

Anakinra (Kineret®)	This High-Cost Drug has been approved for the following indications: - restricted use for adult patients with Secondary Haemophagocytic Lymphohistiocytosis. Approval required from members of the Regional HLH Network. To be prescribed in accordance with the NHSE Clinical Commissioning Policy [210701P] (1924).
For more information and Guidance Click Here	NHSE Clinical Commissioning Policy [210701P] (1924).

Bimekizumab

This High-Cost Drug has been approved for the following indications:

Treatment of axial spondyloarthritis. in adults as per NICE Guidance
Treatment of active psoriatic arthritis in adults as per NICE Guidance

For more information and NICE Guidance Click Here

Bimekizumab for treating axial spondyloarthritis NICE Guidance TA918
ICB commissioned - approval via Blueteq

Bimekizumab for treating active psoriatic arthritis NICE Guidance TA916
ICB commissioned - approval via Blueteq

Filgotinib	This High-Cost Drug has been approved for the following indications: - Moderate to severe rheumatoid arthritis
For more information and NICE Guidance Click Here	Filgotinib for treating moderate to severe rheumatoid arthritis NICE Guidance TA676 ICB commissioned - approval via Blueteq

Guselkumab	This High-Cost Drug has been approved for the following indications: - Active psoriatic arthritis after inadequate response to DMARD
For more information and NICE Guidance Click Here	Guselkumab for treating active psoriatic arthritis after inadequate response to DMARDs NICE Guidance TA815 ICB commissioned - approval via Blueteq

Infliximab biosimilar - Flixabi^®	This High-Cost Drug has been approved for the following indications: - active and progressive psoriatic arthritis as per NICE Guidance severe active ankylosing spondylitis or severe non-radiographic axial spondyloarthritis as per NICE Guidance adults with severe rheumatoid arthritis who have tried conventional DMARDs as per NICE Guidance adults with moderate rheumatoid arthritis who have tried conventional DMARDs as per NICE Guidance rheumatoid arthritis after the failure of a TNF inhibitors per NICE Guidance
For more information and NICE Guidance Click Here	Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis NICE Guidance TA199 ICB commissioned - approval via Blueteq
	TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis NICE Guidance TA383 ICB commissioned - approval via Blueteq
	Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed NICE Guidance TA375 ICB commissioned - approval via Blueteq
	Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor NICE Guidance TA195 ICB commissioned - approval via Blueteq
	Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed NICE Guidance TA715

Risankizumab	This High-Cost Drug has been approved for the following indications: - Treatment of Active Psoriatic arthritis (PsA)
For more information and NICE Guidance Click Here	Risankizumab for treatment of Active Psoriatic arthritis (PsA) NICE Guidance TA803 ICB commissioned - approval via Blueteq

Rituximab	This High-Cost Drug
For more information and NICE Guidance Click Here	see High Cost Drugs Manual for all commissioning indications

Toculizumab Biosimilar Tyenne®	This High-Cost Drug has been approved for the following indications: - for the treatment of systemic juvenile idiopathic arthritis as per NICE Guidance for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed as per NICE Guidance
For more information and NICE Guidance Click Here	Tocilizumab for the treatment of systemic juvenile idiopathic arthritis NICE Guidance TA238 ICB commissioned - approval via Blueteq
	Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis NICE Guidance TA373 NHSE commissioned - Prior approval proforma required via Blueteq
	Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed NICE Guidance TA375 ICB commissioned - approval via Blueteq

Tofacitinib (Xeljanz®)

This High-Cost Drug has been approved for the following indications: -

Treatment of active ankylosing spondylitis that is not controlled well enough with conventional therapy in adults as per NICE Guidance

For more information and NICE Guidance Click Here

Tofacitinib for treating active ankylosing spondylitis NICE Guidance TA920
ICB commissioned - approval via Blueteq

Upadacitinib (Rivoq®)	This High-Cost Drug has been approved for the following indications: - Treatment of moderate rheumatoid arthritis as per NICE Guidance. Treatment of active ankylosing spondylitis that is not controlled well enough with conventional therapy in adults as per NICE Guidance Treatment of active non-radiographic axial spondyloarthritis with objective signs of inflammation that is not controlled well enough with non-steroidal anti-inflammatory drugs in adults as per NICE Guidance.
For more information and NICE Guidance Click Here	Upadacitinib for treating moderate rheumatoid arthritis NICE Guidance TA744 ICB commissioned - approval via Blueteq
	Upadacitinib for treating active ankylosing spondylitis NICE Guidance TA829 ICB commissioned - approval via Blueteq
	Upadacitinib for treating active non-radiographic axial NICE Guidance TA861 ICB commissioned - approval via Blueteq

First Line Choice
On Formulary
Specialist Initiation Only

Hospital Only
KMPT Initiation Only