OBJECTIVE: To review the cost effectiveness of rheumatoid arthritis (RA) treatments and inform the clinical recommendations by the European League Against Rheumatism. METHODS: A systematic literature search and review of the health economic evidence on RA treatment options was performed. RESULTS: Despite diverse methodological approaches, health economic analyses are concordant: at onset of disease, traditional disease-modifying antirheumatic drugs (DMARDs) are cost effective-that is, treatment merits outweigh treatment costs. If DMARDs fail, therapeutic escalation with tumour necrosis factor alpha inhibitors (TNFi) is cost effective when standard dosing schemes are employed. If TNFi fail, rituximab or abatacept is cost effective. Economic evidence for switching TNFi remains sparse. CONCLUSIONS: The costly sequelae of insufficiently controlled RA justify intensive escalations of treatment in this disease. By maintaining function, patients are kept in the work process, reducing indirect costs. Quality of life is improved at an expense commonly accepted for chronic diseases. Effective control of disease activity seems to be a prudent use of societal resources.
OBJECTIVE: To review the cost effectiveness of rheumatoid arthritis (RA) treatments and inform the clinical recommendations by the European League Against Rheumatism. METHODS: A systematic literature search and review of the health economic evidence on RA treatment options was performed. RESULTS: Despite diverse methodological approaches, health economic analyses are concordant: at onset of disease, traditional disease-modifying antirheumatic drugs (DMARDs) are cost effective-that is, treatment merits outweigh treatment costs. If DMARDs fail, therapeutic escalation with tumour necrosis factor alpha inhibitors (TNFi) is cost effective when standard dosing schemes are employed. If TNFi fail, rituximab or abatacept is cost effective. Economic evidence for switching TNFi remains sparse. CONCLUSIONS: The costly sequelae of insufficiently controlled RA justify intensive escalations of treatment in this disease. By maintaining function, patients are kept in the work process, reducing indirect costs. Quality of life is improved at an expense commonly accepted for chronic diseases. Effective control of disease activity seems to be a prudent use of societal resources.
Authors: Larry W Moreland; James R O'Dell; Harold E Paulus; Jeffrey R Curtis; Joan M Bathon; E William St Clair; S Louis Bridges; Jie Zhang; Theresa McVie; George Howard; Désirée van der Heijde; Stacey S Cofield Journal: Arthritis Rheum Date: 2012-09
Authors: M Cárdenas; S de la Fuente; M C Castro-Villegas; M Romero-Gómez; D Ruiz-Vílchez; J Calvo-Gutiérrez; A Escudero-Contreras; J R Del Prado; E Collantes-Estévez; P Font Journal: Rheumatol Int Date: 2016-10-24 Impact factor: 2.631
Authors: M Cárdenas; S de la Fuente; P Font; M C Castro-Villegas; M Romero-Gómez; D Ruiz-Vílchez; J Calvo-Gutiérez; A Escudero-Contreras; M A Casado; J R Del Prado; E Collantes-Estévez Journal: Rheumatol Int Date: 2016-02 Impact factor: 2.631
Authors: Josef S Smolen; Robert Landewé; Ferdinand C Breedveld; Maxime Dougados; Paul Emery; Cecile Gaujoux-Viala; Simone Gorter; Rachel Knevel; Jackie Nam; Monika Schoels; Daniel Aletaha; Maya Buch; Laure Gossec; Tom Huizinga; Johannes W J W Bijlsma; Gerd Burmester; Bernard Combe; Maurizio Cutolo; Cem Gabay; Juan Gomez-Reino; Marios Kouloumas; Tore K Kvien; Emilio Martin-Mola; Iain McInnes; Karel Pavelka; Piet van Riel; Marieke Scholte; David L Scott; Tuulikki Sokka; Guido Valesini; Ronald van Vollenhoven; Kevin L Winthrop; John Wong; Angela Zink; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2010-05-05 Impact factor: 19.103