Biologics on returning to UK

I currently live in France but am thinking about returning to the UK. Can anyone direct me to a web site that gives information (NICE or other) on how it is decided on the meds you are prescribed? Are there lots of hoops to be jumped through before you are given biologics? Having been through several biologics I am now on Rituximab which seems to be going okay so far, and would be reluctant to come back if it was stopped because my RA seemed to be under control. I keep reading posts which gives 'point scoring' - who decides on your points?

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  • Here are links to the NICE info. They are "guidance" not rules so there are cases where doctors don't stick exactly to them. But generally getting biologics is a bit of a process. You have to score over 5.1 on DAS score, which is assessed by rheumatologist or specialist nurse. And they then apply for the funding from the local hospital trust. If yourRA is well controlled you of course won't score highly.

    However, there is an ethical consideration in that if you are already on a drug it is against most doctors ethics to stop it. So this may not apply at all!

    But the other problem you will face is timing. You may be able to persuade current medical team to give you three months supply before you leave. But it could take longer than that to get sorted in U.K. system. So lots of preparation needed, even if your new medical team have no problem with continuing using your treatment. New parient referrals are often 18 weeks, and I think that 18 week target may just have been scrapped

    pathways.nice.org.uk/pathwa...

    nice.org.uk/guidance/cg79

    I went the other way, from UK to France. And it took 7 months to get an appointment with a rheumatologist, but luckily the medécin traitant was happy to prescribe my usual drugs in the meantime. I'm not convinced that all UK GPs would be as obliging.... I had a fantastic rheumy in the UK and leaving her was the most difficult bit about deciding to leave the UK. However having now experienced the French health service I wouldn't go back!

  • Excuse my ignorance HH but what is the significant differences between the two?

    When younger, I worked and lived in Geneva for a while and remember having to go to dentist on two occasions and doctor - cost a small fortune.

    Clearly I was there on a work visa, didn't have residence

    .

    Marie

  • In the U.K. the health service is paid for by funds taken from national insurance/tax and it is free at the point of delivery for patients (apart from prescriptions).

    In France you pay a proportion of your income (8%) every year specifically to join the health service unless you have v low income. But then only a proportion of the costs are covered, usually 65%, and the rest you have to pay for yourself or take out a special insurance to pay for. So it costs a LOT more. Things like RA are in theory covered 100%, but in practice not everything is eligible. Even with that plus my top up insurance I still have to pay about £50 for each pair of insoles. The plus side is that if you need biologics you get them. We live in the middle of nowhere, so there aren't many doctors or specialists and so you do have to wait for some appointments like in UK, but things like an MRI or physiotherapist appointment happen in a matter of days. And if you or family member can't drive to appointment & no public transport then a taxi is paid for, etc etc. So costs more, but you get more. . And the weather's better.

  • That's interesting , I'd no idea how health care functioned in France.

    Absolutely envy you the weather!

    Thanks HH

  • Thanks for the info. I have to admit I am finding it very difficult to decide whether to return or just move to closer to a town/city in France. I live in a very rural setting about 1.5 hrs North of Paris, with no public transport or shops, and in thinking of my future(age) I think I would do better somewhere with more facilities and people. Whereabouts did you move to?

  • We're in a hamlet of 60 people in the Jura mountains in eastern France. Nearest shop is 4km. So same thing for us in due course. I keep eyeing up places on the edge of our local town to see whether that might be possible. But wherever we go Ithink it will be very hard to adapt to somewhere with people and cars and noise! All we have is space and cows.

    The big problem of course is the places I might want to live in the U.K. are probably unaffordable.

    When were you last back in U.K.? It might be worth an extended trip to see how you feel, and maybe if you have a likely area then register with a GP as a temporary visitor and get an appointment to talk about it?

  • I don't really know the answer, but I'm on RTX & have infusions every 6 months, so if you could register with a UK GP as soon after infusion as possible, you might be able to get into the system & be prescribed RTX.

    If you can't do that you might have to go through the DAS score process, which if you have RTX controlling your RA may prove problematic.

    Hope it all works out for you.

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