Campaigners have reacted angrily to news that around 12,000 arthritis sufferers in the UK may be denied access to a new drug which could help relieve their pain.
The National Institute for Health and Clinical Excellence (NICE) has published draft guidance that does not recommend Orencia (abatacept) on the NHS for those with severe arthritis.
Rheumatoid arthritis affects around 400,000 people in the UK, and 40,000 of those have a severe form of the disease.
At the moment they can be offered drugs called anti-TNFs, but around 30% of patients do not benefit from these.
It is this group which could then be eligible to be treated with drugs such as abatacept.
A NICE spokeswoman said: "Having examined cost-effectiveness analyses on abatacept against a range of comparators, the committee concluded that abatacept could not be considered a cost-effective use of NHS resources."
Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said: "From a cost perspective, only those who attain sufficient benefit will remain on treatment. If there is no response then treatment can be stopped very quickly, so minimising cost.
"We simply cannot accept that individuals should be denied the chance of at least regaining some quality of life and condemning them to a life of pain and disability, which could be equally as expensive to the NHS."
The draft NICE guidance is now open to consultation. Final guidance is not expected until the end of the year.