May 2007
OXFORD HOSPITAL’S SOFTWARE INNOVATION SET TO REVOLUTIONISE ADVANCED ARTHRITIS DRUG TREATMENT FOR UK PATIENTS
OXFORD, UK: Oxford’s world-class orthopaedic hospital, the Nuffield Orthopaedic Centre, has pioneered new software - EvaluLogix™ - which will radically simplify the complex process of patient assessment for advanced arthritis treatment and could save the NHS hundreds of thousands of pounds in the process. A licensing deal with global pharmaceutical giant, Roche, has already been signed in the UK.
EvaluLogix has been developed by Dr Raashid Luqmani, a senior consultant at the Nuffield Orthopaedic Centre (NOC) and took an NHS Innovations Awards in 2006. It will enable clinicians to identify easily patients’ suitability for advanced rheumatoid arthritis (RA) treatments – know as biologic therapies. The new software could be used to assess up to 38,0001 patients in the UK who may be helped by these treatments. It is being marketed in the UK by EPS Research.
Biologic therapies are mainly used to treat severe RA. The currently licensed biologic treatments, anti-TNF’s and b-cell therapy rituximab, work in different ways. A new biologic therapy, abatacept, has been given positive opinion by the CHMP and is currently awaiting license, once licensed it will also be monitored through the EvaluLogix system.
Anti-TNF treatment costs between £9,000 and £18,000 per patient per year, and is effective in around 60-70% of cases. As a result, the National Institute for Clinical Excellence (NICE) requires a rigorous and complex assessment of patients before and during treatment, to ensure that anti-TNF is targeted specifically at those likely to respond positively to it. EvaluLogix has been designed to simplify and standardise the assessment process, and is the first software available in the UK to provide this type of decision support for clinical teams. Rituximab, in combination with methotrexate, is indicated for the treatment of adult patients with severe active RA who have had an inadequate response or intolerance to one or more tumour necrosis factor (TNF) inhibitor therapies, and is currently being reviewed by NICE.
Dr Luqmani, Consultant Rheumatologist at the Nuffield Orthopaedic Centre, says: “We see several hundred patients in our department each year, so making manual calculations for each of them based on the highly complex NICE criteria for assessing anti-TNF treatment would have been impossible.
“EvaluLogix offers compelling benefits for clinical teams, such as very accurate assessment of patients for their suitability for anti-TNF therapy against agreed international scoring scales. It also means that we can identify very quickly those patients who are not suitable for certain biologic treatments and put them onto alternative treatments which will work better for them. The system is simple to use, provides robust decision-making and research data, and has the added benefit of reducing administrative workload by automatically generating things like patient and GP letters. It makes our anti-TNF clinic at the Nuffield Orthopaedic Centre extremely efficient and means we can treat more patients.”
Dr John Stedman Chief Executive of NHS Innovations South East is quoted as saying “As part of our working in partnership with the Trust we have been able to bring together Dr Luqmani with a small company such as EPS whose expertise in the development software products for medical applications have made it possible to take a basic spreadsheet and progress it to a software package that was of commercial interest to an international company such as Roche. This is an excellent example of how an NHS clinician can directly improve patient care using innovation. It also acts as an inspiration to other NHS staff, that their ideas are valued and can benefit patients.
- ends -
Note to editors:
About Rheumatoid Arthritis (RA):
• Almost 1% of the UK population (approx 387,000 people) suffer from RA, that’s 1 in 50 of us.2
• People of any age can develop it, but it is most common between the ages of 30 and 50 years, and among women. 3
• It is an incurable, long-term, auto-immune disease which is generally managed using drug therapies and surgery in more severe RA sufferers
• 9.4 million working days were lost because of RA in 1999-2000 in Great Britain.This represents £833 million lost production.2
• Failure to respond to treatment leads to destruction of joints; uncontrolled inflammation leads to the need for surgery to replace joints
• Surgery is an unsatisfactory treatment, therefore disease modification through drug treatment is required
About biologic therapies:
Anti-TNF therapy:
Anti-TNF is a name given to a class of drugs available for the treatment of severe RA. Currently this group consists of three drugs, infliximab (trade name Remicade), etanercept (trade name Enbrel) and adalimumab (trade name Humira). These drugs work by blocking the action of TNF (tumour necrosis factor), a molecule responsible for increasing levels of inflammation in people with RA.
• For the 6-10% of patients who don’t respond to conventional treatment, anti-TNF can offer a solution
• Whilst the release of TNF is a normal part of the immune system in healthy patients, in some suffers of RA, excessive quantities are released. This leads to an ‘over-reaction’ by the patient’s cells and ultimately to inflammation and the destruction of cartilage and bone
• Unfortunately, anti-TNF therapy will not work for everyone (60-70% of patients respond) and it is extremely expensive, costing between £9,000-£18,000 per patient
• If it is successful, anti-TNF treatment does represent good value, offsetting its costs through the benefits to the patient and reduced cost of alternative treatment (such as joint replacements)
• For these reasons, the National Institute of Clinical Evidence (NICE) has limited its use to patients who respond, and continue to respond, well to it
Rituximab:
Rituximab (trade name MabThera®) is a therapeutic antibody that selectively targets B-cells, which have emerged as a target for RA therapy. B-cells play a key role in the inflammatory cascade– a series of reactions that lead to joint inflammation, deformity and loss of function that is characteristic of the disease. It is given in combination with methotrexate, a standard RA treatment.
• Approximately 30% of patients either do not respond to or cannot tolerate anti-TNF’s and for those patients, rituximab is appropriate
• One course of rituximab (2 infusions, given 2 weeks apart) costs £3492.60, the lowest drug cost within the biologic group.
• Rituximab is currently being reviewed by NICE to assess its cost effectiveness.
Abatacept:
Abatacept is yet to be licenced.
About EvaluLogix
At the first visit, the ‘score’ determines whether the patient is likely to benefit from anti-TNF therapy or not, supporting the clinician in making a prescribing decision. Any score over 5.1 means that the patient is suitable for treatment. Based on their score, if the patient is given anti-TNF treatment, their progress will be reviewed after three months, in accordance with NICE requirements. The same tests are re-run on the patient and the data entered. The programme compares the resulting new ‘score’ with the initial ‘score’ and demonstrates how well the patient has responded. If the difference between the first score and second score does not meet minimum NICE requirements, then the patient is identified as not responding to the treatment and will be considered for other treatments. The software is used in subsequent follow-up consultations to ensure that those who showed an initially good response continue to respond to the therapy. Since Dr Luqmani developed the first generation of the software two years ago, the Nuffield Orthopaedic Centre has seen and been able to evaluate over 200 cases.
About the Nuffield Orthopedic Centre
The Nuffield Orthopedic Centre (NOC) is based in the City of Oxford and is one of the world’s leading orthopedic hospitals. It provides specialist services to patients from across the UK and world-wide, and also provides routine and specialist orthopedic and rheumatological services, primarily to the people of Oxfordshire.
The NOC has maintained a distinguished medical and nursing tradition since its beginning in 1872, with a top class reputation for clinical excellence and patient care. The NOC’s team of dedicated staff and consultants work together to put the care and needs of its patients first. It is both a teaching hospital trust - providing a large number of placements and fellowships for trainee physicians and surgeons, nurses and other healthcare professionals in training - and a major research centre which houses many of the leading academics and researchers in the field of musculo-skeletal disorders.
For more information, visit www.noc.nhs.uk.
About NHS Innovations South East
Co funded by the Department of health, Office of Science and Innovation and the Regional Development Agencies, NHS Innovations South East (NISE) is one of nine similar hubs which make up a national network and was set up to provide a service to improve healthcare by assisting NHS Inventors to commercialise their ideas. Innovation managers carry out a thorough assessment of all NHS inventions in order to determine the potential for gaining intellectual property rights, the size, nature and competitiveness of the market, the benefit to patients and Trusts and the potential cost savings for the NHS. This analysis is a mixture of desk based research and consultation with our networks of industry and clinical contacts. In this case NISE determined that the best route to market was one of licensing. By going the route they have NISE believes that they have not only maximised the potential on-going revenue for both the Trusts and inventor but equally importantly this has proved to be the shortest route to offering patients better healthcare.
For more information, visit www.nhsinnovations-southeast.com
For further information contact:
Sally Robinson – Marketing Manager, NHS Innovations South East
Tel: 01235 838539 / 07768 302156
Email sally.robinson@nisehub.co.uk
Marie Maher – Marketing Manager for NHS National Innovations Centre (07946510054)
Kevin McNamara – Communications South Central Strategic Health Authority (01635 275614)
Todd Davidson - Communications Manager, Nuffield Orthopaedic Centre NHS Trust(01865 741155)
References:
1 MedScape Medical News, UK Gains confidence with anti-TNF use, http://www.medscape.com/viewarticle/537766, accessed 24/04/2007
2 Arthritis Research Campaign, Big Picture, http://www.arc.org.uk/arthinfo/bigpic.asp#1, accessed 24/04/2007
3 Arthritis Care, About Rheumatoid Arthritis, http://www.arthritiscare.org.uk/AboutArthritis/Conditions/Rheumatoidarthritis , accessed 24/04/2007
EvaluLogix has been developed by Dr Raashid Luqmani, a senior consultant at the Nuffield Orthopaedic Centre (NOC) and took an NHS Innovations Awards in 2006. It will enable clinicians to identify easily patients’ suitability for advanced rheumatoid arthritis (RA) treatments – know as biologic therapies. The new software could be used to assess up to 38,0001 patients in the UK who may be helped by these treatments. It is being marketed in the UK by EPS Research.
Biologic therapies are mainly used to treat severe RA. The currently licensed biologic treatments, anti-TNF’s and b-cell therapy rituximab, work in different ways. A new biologic therapy, abatacept, has been given positive opinion by the CHMP and is currently awaiting license, once licensed it will also be monitored through the EvaluLogix system.
Anti-TNF treatment costs between £9,000 and £18,000 per patient per year, and is effective in around 60-70% of cases. As a result, the National Institute for Clinical Excellence (NICE) requires a rigorous and complex assessment of patients before and during treatment, to ensure that anti-TNF is targeted specifically at those likely to respond positively to it. EvaluLogix has been designed to simplify and standardise the assessment process, and is the first software available in the UK to provide this type of decision support for clinical teams. Rituximab, in combination with methotrexate, is indicated for the treatment of adult patients with severe active RA who have had an inadequate response or intolerance to one or more tumour necrosis factor (TNF) inhibitor therapies, and is currently being reviewed by NICE.
Dr Luqmani, Consultant Rheumatologist at the Nuffield Orthopaedic Centre, says: “We see several hundred patients in our department each year, so making manual calculations for each of them based on the highly complex NICE criteria for assessing anti-TNF treatment would have been impossible.
“EvaluLogix offers compelling benefits for clinical teams, such as very accurate assessment of patients for their suitability for anti-TNF therapy against agreed international scoring scales. It also means that we can identify very quickly those patients who are not suitable for certain biologic treatments and put them onto alternative treatments which will work better for them. The system is simple to use, provides robust decision-making and research data, and has the added benefit of reducing administrative workload by automatically generating things like patient and GP letters. It makes our anti-TNF clinic at the Nuffield Orthopaedic Centre extremely efficient and means we can treat more patients.”
Dr John Stedman Chief Executive of NHS Innovations South East is quoted as saying “As part of our working in partnership with the Trust we have been able to bring together Dr Luqmani with a small company such as EPS whose expertise in the development software products for medical applications have made it possible to take a basic spreadsheet and progress it to a software package that was of commercial interest to an international company such as Roche. This is an excellent example of how an NHS clinician can directly improve patient care using innovation. It also acts as an inspiration to other NHS staff, that their ideas are valued and can benefit patients.
- ends -
Note to editors:
About Rheumatoid Arthritis (RA):
• Almost 1% of the UK population (approx 387,000 people) suffer from RA, that’s 1 in 50 of us.2
• People of any age can develop it, but it is most common between the ages of 30 and 50 years, and among women. 3
• It is an incurable, long-term, auto-immune disease which is generally managed using drug therapies and surgery in more severe RA sufferers
• 9.4 million working days were lost because of RA in 1999-2000 in Great Britain.This represents £833 million lost production.2
• Failure to respond to treatment leads to destruction of joints; uncontrolled inflammation leads to the need for surgery to replace joints
• Surgery is an unsatisfactory treatment, therefore disease modification through drug treatment is required
About biologic therapies:
Anti-TNF therapy:
Anti-TNF is a name given to a class of drugs available for the treatment of severe RA. Currently this group consists of three drugs, infliximab (trade name Remicade), etanercept (trade name Enbrel) and adalimumab (trade name Humira). These drugs work by blocking the action of TNF (tumour necrosis factor), a molecule responsible for increasing levels of inflammation in people with RA.
• For the 6-10% of patients who don’t respond to conventional treatment, anti-TNF can offer a solution
• Whilst the release of TNF is a normal part of the immune system in healthy patients, in some suffers of RA, excessive quantities are released. This leads to an ‘over-reaction’ by the patient’s cells and ultimately to inflammation and the destruction of cartilage and bone
• Unfortunately, anti-TNF therapy will not work for everyone (60-70% of patients respond) and it is extremely expensive, costing between £9,000-£18,000 per patient
• If it is successful, anti-TNF treatment does represent good value, offsetting its costs through the benefits to the patient and reduced cost of alternative treatment (such as joint replacements)
• For these reasons, the National Institute of Clinical Evidence (NICE) has limited its use to patients who respond, and continue to respond, well to it
Rituximab:
Rituximab (trade name MabThera®) is a therapeutic antibody that selectively targets B-cells, which have emerged as a target for RA therapy. B-cells play a key role in the inflammatory cascade– a series of reactions that lead to joint inflammation, deformity and loss of function that is characteristic of the disease. It is given in combination with methotrexate, a standard RA treatment.
• Approximately 30% of patients either do not respond to or cannot tolerate anti-TNF’s and for those patients, rituximab is appropriate
• One course of rituximab (2 infusions, given 2 weeks apart) costs £3492.60, the lowest drug cost within the biologic group.
• Rituximab is currently being reviewed by NICE to assess its cost effectiveness.
Abatacept:
Abatacept is yet to be licenced.
About EvaluLogix
At the first visit, the ‘score’ determines whether the patient is likely to benefit from anti-TNF therapy or not, supporting the clinician in making a prescribing decision. Any score over 5.1 means that the patient is suitable for treatment. Based on their score, if the patient is given anti-TNF treatment, their progress will be reviewed after three months, in accordance with NICE requirements. The same tests are re-run on the patient and the data entered. The programme compares the resulting new ‘score’ with the initial ‘score’ and demonstrates how well the patient has responded. If the difference between the first score and second score does not meet minimum NICE requirements, then the patient is identified as not responding to the treatment and will be considered for other treatments. The software is used in subsequent follow-up consultations to ensure that those who showed an initially good response continue to respond to the therapy. Since Dr Luqmani developed the first generation of the software two years ago, the Nuffield Orthopaedic Centre has seen and been able to evaluate over 200 cases.
About the Nuffield Orthopedic Centre
The Nuffield Orthopedic Centre (NOC) is based in the City of Oxford and is one of the world’s leading orthopedic hospitals. It provides specialist services to patients from across the UK and world-wide, and also provides routine and specialist orthopedic and rheumatological services, primarily to the people of Oxfordshire.
The NOC has maintained a distinguished medical and nursing tradition since its beginning in 1872, with a top class reputation for clinical excellence and patient care. The NOC’s team of dedicated staff and consultants work together to put the care and needs of its patients first. It is both a teaching hospital trust - providing a large number of placements and fellowships for trainee physicians and surgeons, nurses and other healthcare professionals in training - and a major research centre which houses many of the leading academics and researchers in the field of musculo-skeletal disorders.
For more information, visit www.noc.nhs.uk.
About NHS Innovations South East
Co funded by the Department of health, Office of Science and Innovation and the Regional Development Agencies, NHS Innovations South East (NISE) is one of nine similar hubs which make up a national network and was set up to provide a service to improve healthcare by assisting NHS Inventors to commercialise their ideas. Innovation managers carry out a thorough assessment of all NHS inventions in order to determine the potential for gaining intellectual property rights, the size, nature and competitiveness of the market, the benefit to patients and Trusts and the potential cost savings for the NHS. This analysis is a mixture of desk based research and consultation with our networks of industry and clinical contacts. In this case NISE determined that the best route to market was one of licensing. By going the route they have NISE believes that they have not only maximised the potential on-going revenue for both the Trusts and inventor but equally importantly this has proved to be the shortest route to offering patients better healthcare.
For more information, visit www.nhsinnovations-southeast.com
For further information contact:
Sally Robinson – Marketing Manager, NHS Innovations South East
Tel: 01235 838539 / 07768 302156
Email sally.robinson@nisehub.co.uk
Marie Maher – Marketing Manager for NHS National Innovations Centre (07946510054)
Kevin McNamara – Communications South Central Strategic Health Authority (01635 275614)
Todd Davidson - Communications Manager, Nuffield Orthopaedic Centre NHS Trust(01865 741155)
References:
1 MedScape Medical News, UK Gains confidence with anti-TNF use, http://www.medscape.com/viewarticle/537766, accessed 24/04/2007
2 Arthritis Research Campaign, Big Picture, http://www.arc.org.uk/arthinfo/bigpic.asp#1, accessed 24/04/2007
3 Arthritis Care, About Rheumatoid Arthritis, http://www.arthritiscare.org.uk/AboutArthritis/Conditions/Rheumatoidarthritis , accessed 24/04/2007