Alopecia UK is delighted to learn of the decision made by the National Institute for Health and Care Excellence (NICE) to recommend the JAK inhibitor medicine ritlecitinib for routine commissioning from the NHS, for the treatment of severe alopecia areata* in patients aged 12 and over.

This is the first time that NICE has recommended a licensed treatment for alopecia areata for routine commissioning on the NHS and represents a huge moment for the alopecia areata community, especially anyone who is wishing to try treatment for their condition.  

Alopecia UK played a key role in advocating for this decision, providing patient experiences and expert testimony during the appraisal process to highlight the significant impacts of alopecia areata, an autoimmune hair loss disease that affects people of all age groups and ethnicities.

Ritlecitinib is manufactured by pharmaceutical company Pfizer under the brand name Litfulo. Ritlecitinib received its marketing licence from the Medicines and Healthcare products Regulatory Agency (MHRA) on 1 November 2023.  

Evidence from clinical trials showed nearly 25% of adults and adolescents taking ritlecitinib (Litfulo) saw significant hair regrowth that covered 80% or more of their scalp after 24 weeks (vs 1.6% taking a placebo). After almost a year, the number of patients achieving a response increased further, with over 40% of patients achieving 80% or more scalp hair regrowth.

Alopecia UK CEO Sue Schilling says:

“This is a monumental day for the alopecia areata community. For far too long, patients with alopecia areata have gone without a licensed treatment option available via NHS pathways. Knowing that some within our community have been accessing JAK inhibitor medicines privately, I am pleased that NICE have approved Litfulo for routine commissioning by the NHS. If new treatments are only available privately, it becomes a case of the ‘haves and the have nots’. This latest NICE recommendation will go some way to address this.

Those of us with alopecia know that it is not the ‘cosmetic’ condition that it is sadly perceived as by some, both in the medical profession and wider society. Alopecia areata is an undertreated autoimmune disease that can impact us all in different ways, and we know that some in our community struggle more than others.

I am proud of the key role Alopecia UK has played in advocating for this treatment to be made available via the NHS. I thank our volunteers who took part in this appraisal process and thank the Committee for their work on reaching this decision, which I am sure will be life-changing for some.

Unfortunately, our community faces huge challenges including difficulties in getting a dermatology referral from their GP, unacceptable dermatology waiting times in some areas, and even some NHS Trusts making the decision not to allow dermatology appointments for alopecia patients. Alopecia UK will do what it can, with the limited resources and capacity that we have, to urge key decision makers within the NHS, to invest more into dermatology services and keep referral pathways open for patients with alopecia areata. The excuse of there being no licensed treatments available has now gone. Patients with alopecia areata deserve better treatment and it is now time they start to receive it.

We will, of course, also continue our work to provide information to on how to live well with alopecia, so that those who either cannot have treatment, are unsuccessful with treatment, or choose not to have treatment, are empowered with confidence. This work is just as important to us as our work to advocate for fairer treatment pathways.”

Ritlecitinib (Litfulo) is a prescription medicine, from a group of medications called Janus kinase (JAK) inhibitors, that works inside the body to treat severe alopecia areata. Ritlecitinib (Litfulo) binds to select proteins within immune cells and blocks their signalling process to decrease the number of immune cells attacking the hair follicle. 

We know that the news of NICE’s recommendation of ritlecitinib (Litfulo) for routine commissioning via the NHS will lead to lots of questions from our community. We may not have all the answers immediately, but we have pulled together some information below that we hope you will find helpful. Please read through the information provided before contacting us with any further questions. 

Please also note that Alopecia UK cannot give medical advice and we urge anyone with any questions about treatment to address those to their doctors in the first instance.

* severe alopecia areata includes alopecia totalis and alopecia universalis 

Further information: 

We have pulled together some further pages which may prove helpful. We will continue to share more information as details of the treatment pathway becomes clearer.

Frequently Asked Questions

How is severity of alopecia areata graded? (SALT scoring explained)

What does the clinical trials data show for ritlecitinib (Litfulo)?

JAK inhibitors - treatment options, not a cure

Alopecia UK Community Narrative