An arthritis drug that may not be made available to NHS patients in England and Wales has been given the green light in Scotland.
Tocilizumab has provisionally been judged too expensive by the National Institute for Health and Clinical Excellence (Nice), which assesses the cost effectiveness of treatments in England and Wales.
But the body's Scottish equivalent, the Scottish Medicines Consortium (SMC) issued its own guidance recommending free treatment with the drug.
Tocilizumab, marketed under the name RoActemra, reduces painful symptoms of rheumatoid arthritis. Used with the standard anti-inflammatory drug methotrexate (MTX) it has been found to improve remission rates six-fold.
Nice has indicated in its draft guidance that the drug, which costs £9,000 per patient per year, is too expensive to justify use on the NHS.
In December the organisation issued an unusual statement saying its final decision could be swayed by sufficiently persuasive new evidence. It challenged the drug's makers Roche to prove that its product really was cost effective.
Sufferers of rheumatoid arthritis who do not respond to other therapies already have access to the drug in most of continental Europe.
The new guidance in Scotland recommends tocilizumab in combination with MTX for moderate to severe rheumatoid arthritis when other treatment options have run out.
The SMC says that use of the drug will probably cost £1.2million in the first year, rising to £7million in five years, based on an estimate of 127 patients being treated in the first year, rising to 758 patients in year five. An additional cost will increase the cost to £1.4million in the first year and £8.5million by the fifth year.
Leading rheumatologist Professor John Isaacs, from the Institute of Cellular Medicine at the University of Newcastle, said: "This is fantastic news for people in Scotland who suffer from this disabling, life-long disease. However, it also highlights the disparities in accessing treatment between Scotland and the rest of the UK."
Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said: "The SMC's decision provides people with rheumatoid arthritis in Scotland who face a life of pain and potential disability another chance of combating their disease.
"We strongly hope that Nice will revise its draft guidance to ensure that people with rheumatoid arthritis across the country are able to benefit from RoActemra."
An estimated 646,000 people in the UK have rheumatoid arthritis, an auto-immune disease that attacks the joints.
A third of affected adults will have stopped working within two years of the disease taking hold and around half will be too disabled to work within ten years.
