Campaigners have condemned proposals to block NHS funding of a new drug for severe rheumatoid arthritis in England and Wales.
Rheumatoid arthritis is a painful auto-immune disease
Draft guidance from the National Institute for Health and Clinical Excellence (NICE) says Orencia is not a cost-effective option for the NHS.
The National Rheumatoid Arthritis Society described the move as "devastating news".
It said Orencia could potentially benefit 12,000 people in the UK alone.
Rheumatoid arthritis is a painful and often crippling disease which occurs when the immune system attacks the joints, causing swelling and damage of cartilage and bone.
The National Rheumatoid Arthritis Society estimates that around 40,000 people in the UK have severe rheumatoid arthritis.
Of these around 30% fail to respond to the standard treatment - drugs called anti-TNFs.
The drugs makers, Bristol-Myers Squibb, estimate the number of people who could benefit to be lower - but at more than 3,500, still significant.
Ailsa Bosworth, chief executive of NRAS, said it would be wrong to deny this group the option of taking Orencia (technical name: abatacept).
She said they would be faced with taking treatments which had already failed them, palliative care, or taking large doses of steroids which can have side effects such as osteoporosis when used in the long term.
She said patients who failed to respond to Orencia could stop taking it quickly, keeping cost to a minimum.
"We simply cannot accept that individuals should be denied the chance of at least regaining some quality of life and condemning them to a life of pain and disability, which could be equally as expensive to the NHS."
A NICE spokeswoman said an independent advisory committee had decided the drug was not a cost effective option after carrying out a detailed assessment.
The draft Nice guidance is now open to consultation. Final guidance is not expected until the end of the year.
An Austrian study published in The Lancet in June found Orencia - and two other similar drugs called MabThera, Tocilizumab - slowed progression of the rheumatoid arthritis and reduced symptoms.
The drugs work by targeting the immune system, but have side effects, including an increased vulnerability to infections.