Cost Effectiveness of TNF- Inhibitors in Rheumatoid Arthritis (original) (raw)
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Health technology assessment (Winchester, England), 2006
This report reviews the clinical effectiveness and cost-effectiveness of adalimumab, etanercept and infliximab, agents that inhibit tumour necrosis factor-alpha (TNF-alpha), when used in the treatment of rheumatoid arthritis (RA) in adults. Electronic databases were searched up to February 2005. Systematic reviews of the literature on effectiveness and cost-effectiveness were undertaken and industry submissions to the National Institute for Health and Clinical Excellence (NICE) were reviewed. Meta-analyses of effectiveness data were also undertaken for each agent. The Birmingham Rheumatoid Arthritis Model (BRAM), a simulation model, was further developed and used to produce an incremental cost-effectiveness analysis. Twenty-nine randomised controlled trials (RCTs), most of high quality, were included. The only head-to-head comparisons were against methotrexate. For patients with short disease duration (<or=3 years) who were naïve to methotrexate, adalimumab was marginally less an...
BioMed Research International, 2021
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
Effectiveness and Costs of TNF-Alpha Blocker Use for Patients with Rheumatoid Arthritis
American health & drug benefits, 2013
Rheumatoid arthritis (RA) is ranked among the highest of all chronic diseases in terms of its adverse impact on health-related quality of life, limitations in physical function, increased pain and fatigue, and diminished work performance and attendance compared with other debilitating chronic conditions. To compare healthcare expenditures, utilization, and productivity-related outcomes for patients with RA using tumor necrosis factor (TNF)-alpha blockers compared with patients with mild, moderate, or severe RA who are not using these medications. Patients with RA were identified from the 1998-2007 Medical Expenditure Panel Survey database, using International Classification of Diseases, Ninth Revision, Clinical Modification codes (714.xx); the patients were classified as (1) TNF-alpha blocker users, identified on the basis of pharmacy or intravenous therapy utilization, or (2) TNF-alpha blocker nonusers (but could be using other RA-related medications). Patients who were not using T...
The Journal of Rheumatology, 2008
Objective. To 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). Methods. Because 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. Results. Treatment 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 47,157excludingproductivitylosses,and47,157 excluding productivity losses, and 47,157excludingproductivitylosses,and19,663 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. Conclusion. Of 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. (First Release