A newly developed drug designed to ease the suffering of patients with rheumatoid arthritis may be too expensive for the NHS to provide.
Trials of tocilizumab have revealed that the powerful "smart" drug can help patients who no longer respond to or tolerate other therapies.
The drug is the first of its kind to target a key signalling molecule that lies at the foundation of many inflammatory processes. The life-changing medicine costs £9,300 per year for one patient, but concerns have arisen that it will be too costly for the NHS.
The National Institute for Health and Clinical Excellence (NICE) issued preliminary guidance on October 1 advising against the new medicine. Without NICE approval, primary care trusts are highly unlikely to pay for the drug.
The National Rheumatoid Arthritis Society (NRAS), a charity supporting sufferers of the disease, described the decision as "extremely bad news".
It remains to be seen whether the recommendation will be reversed or altered by the time NICE produces its final guidance early next year.
Meanwhile, the Scottish Medicines Consortium is expected to issue separate guidance for tocilizumab north of the border.
A possible outcome might be that the drug's manufacturer, pharmaceutical giants Roche, strikes a deal to share the cost burden with the NHS.