scholarly journals Modelling the cost effectiveness of TNF-  antagonists in the management of rheumatoid arthritis: results from the British Society for Rheumatology Biologics Registry

Rheumatology ◽  
2007 ◽  
Vol 46 (8) ◽  
pp. 1345-1354 ◽  
Author(s):  
A. Brennan ◽  
N. Bansback ◽  
R. Nixon ◽  
J. Madan ◽  
M. Harrison ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
British Society ◽  
Tnf Antagonists ◽  
The Cost

Cost-Effectiveness of Sequential Therapy with Tumor Necrosis Factor Antagonists in Early Rheumatoid Arthritis

2009 ◽  
Vol 36 (1) ◽  
pp. 16-26 ◽  
Author(s):  
ANDREW DAVIES ◽  
MARY A. CIFALDI ◽  
OSCAR G. SEGURADO ◽  
MICHAEL H. WEISMAN
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Tumor Necrosis ◽  
Cost Effective ◽  
Tnf Antagonists ◽  
Productivity Losses ◽  
Line Therapy ◽  
Tnf Antagonist ◽  
The Cost ◽  
Necrosis Factor

ObjectiveTo estimate the comparative lifetime cost-effectiveness of sequenced therapy with tumor necrosis factor (TNF) antagonists as the initial therapeutic intervention for patients with early rheumatoid arthritis (RA).MethodsBecause patients with RA switch regimens many times throughout the course of disease, sequenced therapeutic interventions were modeled, continuing until the last effective agent failed or death occurred. The model used published clinical outcomes from short-term, randomized controlled trials. Direct treatment costs and costs of lost productivity were modeled for each of 5 alternative treatment sequences. Incremental cost-effectiveness ratios are expressed as quality-adjusted lifeyears (QALY) gained.ResultsTreatment sequences that included TNF antagonists produced a greater number of QALY than conventional disease modifying antirheumatic drug regimens alone. The cost-effectiveness of sequenced therapy initiated with adalimumab plus methotrexate (MTX) extendedly dominated both infliximab-plus-MTX–initiated and etanercept sequences. The cost of adalimumab plus MTX per QALY was US $47,157 excluding productivity losses, and $19,663 including productivity losses. A supplementary sequence that incorporated adalimumab-plus-MTX–initiated first-line therapy followed by another TNF antagonist as second-line therapy was modeled; this sequence resulted in additional QALY gained and extendedly dominated all single-TNF strategies.ConclusionOf the 3 single-TNF antagonist sequences, the adalimumab-plus-MTX–initiated sequence was cost-effective in producing the greatest number of QALY. Multiple TNF strategies, such as the supplementary sequence modeled in this analysis, may be cost-effective in producing even greater health gain.

scholarly journals Cost-Effectiveness Analysis of Biopharmaceuticals for Treating Rheumatoid Arthritis: Infliximab, Adalimumab, and Etanercept

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Ahmad Gholami ◽  
Jassem Azizpoor ◽  
Elham Aflaki ◽  
Mehdi Rezaee ◽  
Khosro Keshavarz
Keyword(s):  
Rheumatoid Arthritis ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
The Other ◽  
Cost Data ◽  
Fars Province ◽  
Study Results ◽  
The Mean ◽  
The Cost

Introduction. Rheumatoid arthritis (RA) is a chronic progressive inflammatory disease that causes joint destruction. The condition imposes a significant economic burden on patients and societies. The present study is aimed at evaluating the cost-effectiveness of Infliximab, Adalimumab, and Etanercept in treating rheumatoid arthritis in Iran. Methods. This is a cost-effectiveness study of economic evaluation in which the Markov model was used. The study was carried out on 154 patients with rheumatoid arthritis in Fars province taking Infliximab, Adalimumab, and Etanercept. The patients were selected through sampling. In this study, the cost data were collected from a community perspective, and the outcomes were the mean reductions in DAS-28 and QALY. The cost data collection form and the EQ-5D questionnaire were also used to collect the required data. The results were presented in the form of an incremental cost-effectiveness ratio, and the sensitivity analysis was used to measure the robustness of the study results. The TreeAge Pro and Excel softwares were used to analyze the collected data. Results. The results showed that the mean costs and the QALY rates in the Infliximab, Adalimumab, and Etanercept arms were $ 79,518.33 and 12.34, $ 91,695.59 and 13.25, and $ 87,440.92 and 11.79, respectively. The one-way sensitivity analysis confirmed the robustness of the results. In addition, the results of the probabilistic sensitivity analysis (PSA) indicated that on the cost-effectiveness acceptability curve, Infliximab was in the acceptance area and below the threshold in 77% of simulations. The scatter plot was in the mentioned area in 81% and 91% of simulations compared with Adalimumab and Etanercept, respectively, implying lower costs and higher effectiveness than the other two alternatives. Therefore, the strategy was more cost-effective. Conclusion. According to the results of this study, Infliximab was more cost-effective than the other two medications. Therefore, it is recommended that physicians use this medication as the priority in treating rheumatoid arthritis. It is also suggested that health policymakers consider the present study results in preparing treatment guidelines for RA.

The cost-effectiveness of TNF-inhibitors for the treatment of rheumatoid arthritis in Swedish clinical practice

2012 ◽  
Vol 14 (6) ◽  
pp. 863-873 ◽  
Author(s):  
Ingrid Lekander ◽  
Fredrik Borgström ◽  
Jörgen Lysholm ◽  
Ronald F. van Vollenhoven ◽  
Staffan Lindblad ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Cost Effectiveness ◽  
Tnf Inhibitors ◽  
The Cost

scholarly journals The Effect of Dose Escalation on the Cost-Effectiveness of Etanercept and Adalimumab with Methotrexate Among Patients with Moderate to Severe Rheumatoid Arthritis

2020 ◽  
Vol 26 (10) ◽  
pp. 1236-1242
Author(s):  
Devin Incerti ◽  
Ervant J. Maksabedian Hernandez ◽  
Joseph Tkacz ◽  
Jeroen P. Jansen ◽  
David Collier ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Dose Escalation ◽  
Severe Rheumatoid Arthritis ◽  
The Cost

The cost-effectiveness of aquatic physiotherapy for patients with rheumatoid arthritis

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e465
Author(s):  
P.C. Goodwin ◽  
K. Al Qubaeissy ◽  
A.M. Yohannes ◽  
F. Fatoye
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
The Cost

Cost-effectiveness of etanercept treatment in early active rheumatoid arthritis followed by dose adjustment

2011 ◽  
Vol 27 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Gisela Kobelt ◽  
Ingrid Lekander ◽  
Andrea Lang ◽  
Bernd Raffeiner ◽  
Costantino Botsios ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Cost Effectiveness ◽  
Disease Activity ◽  
Dose Reduction ◽  
Societal Perspective ◽  
Active Rheumatoid Arthritis ◽  
Biologic Treatment ◽  
Early Ra ◽  
The Cost

Objectives: To explore the cost-effectiveness of early biologic treatment, followed by dose-reduction in the case of remission, of active rheumatoid arthritis (RA), compared with standard treatment with methotrexate (MTX) in Sweden.Methods: Effectiveness (function, disease activity, erosions) in early RA for both alternatives was taken from a clinical trial comparing etanercept (ETA) combined with MTX to MTX alone. Patients discontinuing treatment can switch to another or their first biologic treatment. For patients in remission (Disease Activity Score [DAS28] < 2.6), ETA is reduced to half the dose. Return to full dose occurs when DAS28 reaches ≥ 3.2 again. Costs and utilities by level of functional capacity from an observational study are used. The model is analyzed as a micro-simulation and results are presented from the societal perspective for Sweden, for 10 years; costs (€2008) and effects are discounted at 3 percent. Sensitivity analysis was performed for the perspective, the time horizon, switching, and dose-reduction.Results: The main analysis conservatively assumes 50 percent switching at discontinuation. The cost per quality-adjusted life-year (QALY) gained with early ETA/MTX treatment is €13,500 (societal perspective, incremental cost of €15,500 and incremental QALYs of 1.15). With 75 percent switching, the cost per QALY gained was €10,400. Over 20 years, the cost per QALY gained was €8,200. Results were further sensitive to the time patients remained on half dose and the perspective.Conclusions and Policy Implications: This study combines clinical trial and clinical practice data to explore cost-effective treatment scenarios in early RA, including the use of biologics. Our results indicate that a situation where a considerable proportion of patients achieve remission, dose-adjustments will increase the cost-effectiveness of treatment.

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