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Cost effectiveness analysis of disease modifying antirheumatic drugs in rheumatoid arthritis

Manathip Osiri1, Pirom Kamolratanakul, Andreas Maetzel

  • 1Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand. Manathip.O@chula.ac.th

Rheumatology International
|April 19, 2007
PubMed

Insights

Methotrexate plus antimalarials (AM) is a cost-effective rheumatoid arthritis (RA) treatment. Non-methotrexate (MTX) based disease-modifying antirheumatic drugs (DMARDs) were not cost-effective for RA.

Area of Science:

  • Rheumatology
  • Health Economics
  • Pharmacoeconomics

Background:

  • Rheumatoid arthritis (RA) management involves disease-modifying antirheumatic drugs (DMARDs).
  • Antimalarials (AM) are a common RA treatment option.
  • Assessing the cost-effectiveness of different DMARDs against AM is crucial for optimal resource allocation.

Purpose of the Study:

  • To evaluate the cost-effectiveness of various DMARDs compared to antimalarials (AM) in rheumatoid arthritis (RA) treatment.
  • To determine the most economically viable treatment strategies for RA patients.

Main Methods:

  • A 1-year cohort study of 152 RA patients was conducted.
  • Data collected included disease activity, functional status (Health Assessment Questionnaire - HAQ), and societal costs.
  • Incremental Cost-Effectiveness Ratio (ICER) was calculated comparing DMARDs to AM per unit of HAQ improvement.

Main Results:

  • Mean societal cost of AM treatment was US$2,285 per patient annually.
  • Methotrexate (MTX) plus AM was more effective and less costly than AM alone, saving US$834 per 1 unit of HAQ improvement.
  • MTX + sulfasalazine (SSZ), leflunomide, and triple therapy (AM + MTX + SSZ) were more effective but incurred additional costs compared to AM.

Conclusions:

  • RA treatment combining MTX with AM demonstrates superior cost-effectiveness.
  • Non-MTX-based DMARDs were not found to be cost-effective for RA treatment in this study.
  • Combination therapy including MTX offers a potentially more economical approach to RA management.

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