Waiting times halved for rheumatoid arthritis patients, and £100k a year saved, at MRI

Waiting times have been halved for rheumatoid arthritis patients prescribed biologic therapies and £100,000 is being saved every year at Manchester Royal Infirmary (MRI), following the introduction of a Virtual Biologics Clinic.

Rheumatoid arthritis (RA) is a chronic disease which affects up to 1.5% of the population.  It is a significant health burden for patients, who can experience pain, reduced mobility and premature death unless they receive effective treatment.

The introduction of biologics has revolutionised the care of patients with RA, reducing these symptoms and longer-term risk of joint damage and disability. As such, these drugs are now a major component of modern-day treatment for the disease.

However, they are not the most suitable medication for all patients, who differ greatly in their needs, and they are significantly more costly than other treatments. This is why Manchester Royal Infirmary has taken action to avoid an unnecessary financial burden on the NHS, while providing biologics to the patients who will benefit from them as quickly as possible.

Sandhya Sharma, a patient with rheumatoid arthritis from Withington explains, “I was diagnosed soon after my daughter, Rosa, was born.  I was continually exhausted and the pain was excruciating; I had to move back up to Manchester so that family could help me out.

“At the Kellgren Centre for Rheumatology in the MRI I was given the opportunity to take part in a clinical trial.  Since starting on biologics, my life has totally changed – I can be a bigger part of my daughter’s life, and I’ve even started volunteering in the field I’m passionate about – women’s rights.  I’m really happy to have been part of a trial. I have benefitted from having increased care and support which has been extremely positive.  Someone has to step forward to test new ideas. I never thought it would be me, but it’s really important to be that person and hopefully make a difference to other patients.”

The Virtual Biologics Clinic at the Kellgren Centre for Rheumatology was introduced in August 2013 to ensure that the prescription of biologic therapies was based primarily on the needs of patients and not on cost, to increase the speed at which patients gain access to the treatments, and provide more opportunities for patients to participate in clinical research so they may benefit from cutting-edge therapies and to improve the medical community’s knowledge of the disease.

Its aims are in line with the regional biologics pathway for RA, which was devised by the Greater Manchester rheumatology community in June 2013, and the aim of the National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit (BRU) to treat arthritis “right first time”.

Consultant Rheumatologist at the Kellgren Centre for Rheumatology and honorary senior lecturer at The University of Manchester, Dr Ben Parker, explains: “It is a weekly hour-long clinic that brings together nurses, consultants and pharmacists to assess a patient’s needs.  As well as making the process more efficient for patients and the NHS, the Virtual Biologics Clinic supports our research.

“Every patient is assessed for possible research participation and if eligible is approached to discuss their potential involvement.  This is good for patients, because those offered the chance to participate in trials often have improved health outcomes and a better experience of healthcare.”

Professor Ian Bruce, Director of the NIHR Manchester Musculoskeletal BRU adds,
“Dr Parker and the team have had a real impact in using the best available evidence to drive up the quality of care we provide for our patients with RA. They have also achieved this whilst making real cost efficiencies and widening the access to clinical research in our centre”.

The Virtual Biologics Clinic was supported through the MAHSC Improvement Science for Academics (IS4Ac) course, delivered by Haelo, Salford’s innovation and improvement science centre, for MAHSC’s Population Health and Implementation Domain.