FRI0155 Long-term cost-utility analysis of treatment strategies in patients with recent-onset rheumatoid arthritis – 5 year follow-up data from the best study

Abstract Background Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in hospital of older patients with pacemakers, 5 years after implant. Methods Under a controlled, not randomized, nor masked clinical trial, 83 patients with pacemakers were initially selected. After five years of follow-up, a total of 55 patients (CM = 34; RM = 21) completed the study. A cost-utility analysis of RM in terms of costs per gained quality-adjusted life years (QALYs) was conducted. The costs from the Public Health System (PHS) as well as patients and their relatives were taken into account for the study. The robustness of the results was verified by the probabilistic analyses through Monte-Carlo simulations. Results After a five-year follow-up period, total costs were lower in the RM group by 23.02% than in the CM group (€274.52 versus €356.62; p = 0.033) because of a cost saving from patients’ perspective (€59.05 versus €102.98; p = 0.002). However, the reduction of in-hospital visits derived from RM exhibited insignificant impact on the costs from the PHS perspective, with a cost saving of 15.04% (€215.48 vs. €253.64; p = 0.144). Costs/QALYs obtained by the RM group were higher as compared to the CM group, although there were no significant differences. The incremental cost-effectiveness ratio of CM in comparison to RM became positive (€301.16). Conclusions This study confirms RM of older patients with pacemakers appears still as a cost-utility alternative to CM in hospital after 5 years of follow-up. Trial registration ClinicalTrials.gov: (Identifier: NCT02234245). Registered 09 September 2014 - Prospectively registered.

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PMS58 COST-UTILITY ANALYSIS OF DIFFERENT TREATMENT STRATEGIES AFTER THE FAILURE OF FIRST BIOLOGIC TREATMENT IN RHEUMATOID ARTHRITIS (RA) IN THE FINNISH SETTING

Value in Health ◽

10.1016/s1098-3015(10)75196-2 ◽

2009 ◽

Vol 12 (7) ◽

pp. A444

Author(s):

TA Hallinen ◽

EJ Soini ◽

K Eklund ◽

K Puolakka

Keyword(s):

Rheumatoid Arthritis ◽

Treatment Strategies ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis ◽

Biologic Treatment

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PCV96 Cost-Utility Analysis of the Long-Term Cardiovascular Prevention Program in Russian Federation as an Argument for the Widespread Introduction of Preventive Technologies Into Clinical Practice

Value in Health ◽

10.1016/j.jval.2011.08.816 ◽

2011 ◽

Vol 14 (7) ◽

pp. A381

Author(s):

A. Kontsevaya ◽

A. Kalinina ◽

A. Deev

Keyword(s):

Clinical Practice ◽

Russian Federation ◽

Prevention Program ◽

Cardiovascular Prevention ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis

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Health economic measures in schizophrenia research

The British Journal of Psychiatry ◽

10.1192/bjp.191.50.s42 ◽

2007 ◽

Vol 191 (S50) ◽

pp. s42-s45 ◽

Cited By ~ 10

Author(s):

Paul McCrone

Keyword(s):

Health Economic ◽

Economic Evaluation ◽

Cost Utility ◽

Outcome Data ◽

Cost Utility Analysis ◽

Economic Evaluations ◽

Utility Analysis ◽

Short Term ◽

Effectiveness Analysis

BackgroundIt is essential in economic evaluations of schizophrenia interventions that all relevant costs are identified and measured appropriately Also of importance is the way in which cost data are combined with information on outcomesAimsTo examine the use of health economicsin evaluations of interventions for schizophreniaMethodsAreview of the key methods used to estimate costs and to link costs and outcomes was conductedResultsCosts fall on a number of different agencies and can be short term or long term. Cost-effectiveness analysis and cost-utility analysis are the most appropriate methods for combing cost and outcome dataConclusionsSchizophrenia poses a number of challenges for economic evaluation

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Cost utility analysis of long-term telemonitoring of patients with DMT2: Results of the Greek pilot of the renewing health multicenter pragmatic randomized trial

International Journal of Integrated Care ◽

10.5334/ijic.1767 ◽

2014 ◽

Vol 14 (8) ◽

Author(s):

George E. Dafoulas ◽

Afentoula Mavrodi ◽

Alexandra Bargiota ◽

Haralambos Giannakakos ◽

Panagiotis Stafylas ◽

...

Keyword(s):

Randomized Trial ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis

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Does immunological remission, defined as disappearance of autoantibodies, occur with current treatment strategies? A long-term follow-up study in rheumatoid arthritis patients who achieved sustained DMARD-free status

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2018-214868 ◽

2019 ◽

Vol 78 (11) ◽

pp. 1497-1504 ◽

Cited By ~ 3

Author(s):

Debbie M Boeters ◽

Leonie E Burgers ◽

René EM Toes ◽

Annette van der Helm-van Mil

Keyword(s):

Rheumatoid Arthritis ◽

Treatment Strategies ◽

Signs And Symptoms ◽

Current Treatment ◽

Dmard Therapy ◽

Before And After ◽

Long Term Follow Up ◽

Free Status

ObjectivesSustained disease-modifying antirheumatic drug (DMARD)-free status, the sustained absence of synovitis after cessation of DMARD therapy, is infrequent in autoantibody-positive rheumatoid arthritis (RA), but approximates cure (ie, disappearance of signs and symptoms). It was recently suggested that immunological remission, defined as disappearance of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF), underlies this outcome. Therefore, this long-term observational study determined if autoantibodies disappear in RA patients who achieved sustained DMARD-free remission.MethodsWe studied 95 ACPA-positive and/or RF-positive RA patients who achieved DMARD-free remission after median 4.8 years and kept this status for the remaining follow-up (median 4.2 years). Additionally, 21 autoantibody-positive RA patients with a late flare, defined as recurrence of clinical synovitis after a DMARD-free status of ≥1 year, and 45 autoantibody-positive RA patients who were unable to stop DMARD therapy (during median 10 years) were studied. Anti-cyclic citrullinated peptide 2 (anti-CCP2) IgG, IgM and RF IgM levels were measured in 587 samples obtained at diagnosis, before and after achieving DMARD-free remission.Results13% of anti-CCP2 IgG-positive RA patients had seroreverted when achieving remission. In RA patients with a flare and persistent disease this was 8% and 6%, respectively (p=0.63). For anti-CCP2 IgM and RF IgM, similar results were observed. Evaluating the estimated slope of serially measured levels revealed that RF levels decreased more in patients with than without remission (p<0.001); the course of anti-CCP2 levels was not different (p=0.66).ConclusionsSustained DMARD-free status in autoantibody-positive RA was not paralleled by an increased frequency of reversion to autoantibody negativity. This form of immunological remission may therefore not be a treatment target in patients with classified RA.

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