Cost-effectiveness of anti-tumor necrosis factor agents

Rheumatoid arthritis can lead to substantial morbidity, disability and mortality. The development of anti-tumor necrosis factor antibodies from the bench to the bedside over the past 15 years has ushered in the new era of biologic therapies for rheumatic diseases. Etanercept, infliximab and adalimumab have all been approved for the treatment of rheumatoid arthritis on the basis of improved clinical outcomes. Because these treatments, however, are expensive and not uniformly effective, concerns have arisen regarding their cost-effectiveness. This paper reviews the disease burden of rheumatoid arthritis, costs of drug therapy, costs of rheumatoid arthritis and the economics and cost-effectiveness of anti-tumor necrosis factor antibody agents.