TY - JOUR
T1 - Economic aspects of treatment options in rheumatoid arthritis
T2 - a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis
AU - Schoels, Monika
AU - Wong, John
AU - Scott, David L.
AU - Zink, Angela
AU - Richards, Pamela
AU - Landewe, Robert
AU - Smolen, Josef S.
AU - Aletaha, Daniel
PY - 2010/6
Y1 - 2010/6
N2 - 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 a 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.
AB - 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 a 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.
U2 - 10.1136/ard.2009.126714
DO - 10.1136/ard.2009.126714
M3 - Literature review
C2 - 20447950
SN - 1468-2060
VL - 69
SP - 995
EP - 1003
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 6
ER -