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TNF inhibitors in the treatment of rheumatoid arthritis in clinical practice: costs and outcomes in a follow up study of patients with RA treated with etanercept or infliximab in southern Sweden.

Kobelt, G; Eberhardt, Kerstin LU and Geborek, Pierre LU (2004) In Annals of the Rheumatic Diseases 63(1). p.4-10
Abstract
Objectives: To evaluate costs, benefits, and cost effectiveness of tumour necrosis factor inhibitor treatment over one year in routine clinical practice.



Materials and methods: At four rheumatology units in southern Sweden treatment of 160 consecutive patients with RA was started with either etanercept or infliximab. The economic analysis was based on 116 patients with complete data who received treatment for at least one year. Details on drug treatment, functional capacity, disease activity, and laboratory values were available during the entire treatment. Information on resource use and QoL was collected at baseline and throughout the first year. The cost effectiveness analysis was based on changes in outcome and costs... (More)
Objectives: To evaluate costs, benefits, and cost effectiveness of tumour necrosis factor inhibitor treatment over one year in routine clinical practice.



Materials and methods: At four rheumatology units in southern Sweden treatment of 160 consecutive patients with RA was started with either etanercept or infliximab. The economic analysis was based on 116 patients with complete data who received treatment for at least one year. Details on drug treatment, functional capacity, disease activity, and laboratory values were available during the entire treatment. Information on resource use and QoL was collected at baseline and throughout the first year. The cost effectiveness analysis was based on changes in outcome and costs compared with the year before treatment. Cost per quality adjusted life year (QALY) gained was calculated for the entire sample and for patients with different levels of functional disability.



Results: During the first treatment year direct costs were reduced by 40%, but indirect costs did not change substantially. Patients’ QoL improved on treatment—utility increased from an average of 0.28 to 0.65. Assuming that improvement occurred after three months’ treatment, the cost per QALY gained is estimated as €43 500. If it occurs after six weeks, in parallel with clinical measures, the cost per QALY is €36 900. Sensitivity analysis, including all 160 patients, gave an estimated cost per QALY of €53 600. The cost per QALY increases for patient groups with less severe disease.



Conclusion: For this patient group, cost effectiveness ratios are within the generally accepted threshold of €50 000, but need to be confirmed with larger samples. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
63
issue
1
pages
4 - 10
publisher
British Medical Association
external identifiers
  • wos:000187808300002
  • pmid:14672883
  • scopus:0347950999
ISSN
1468-2060
DOI
10.1136/ard.2003.010629
language
English
LU publication?
yes
id
a8e7ec17-962d-4698-8969-4b290eeb585c (old id 119641)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14672883&dopt=Abstract
date added to LUP
2007-07-04 13:29:40
date last changed
2017-10-22 04:33:16
@article{a8e7ec17-962d-4698-8969-4b290eeb585c,
  abstract     = {Objectives: To evaluate costs, benefits, and cost effectiveness of tumour necrosis factor inhibitor treatment over one year in routine clinical practice.<br/><br>
<br/><br>
Materials and methods: At four rheumatology units in southern Sweden treatment of 160 consecutive patients with RA was started with either etanercept or infliximab. The economic analysis was based on 116 patients with complete data who received treatment for at least one year. Details on drug treatment, functional capacity, disease activity, and laboratory values were available during the entire treatment. Information on resource use and QoL was collected at baseline and throughout the first year. The cost effectiveness analysis was based on changes in outcome and costs compared with the year before treatment. Cost per quality adjusted life year (QALY) gained was calculated for the entire sample and for patients with different levels of functional disability.<br/><br>
<br/><br>
Results: During the first treatment year direct costs were reduced by 40%, but indirect costs did not change substantially. Patients’ QoL improved on treatment—utility increased from an average of 0.28 to 0.65. Assuming that improvement occurred after three months’ treatment, the cost per QALY gained is estimated as €43 500. If it occurs after six weeks, in parallel with clinical measures, the cost per QALY is €36 900. Sensitivity analysis, including all 160 patients, gave an estimated cost per QALY of €53 600. The cost per QALY increases for patient groups with less severe disease.<br/><br>
<br/><br>
Conclusion: For this patient group, cost effectiveness ratios are within the generally accepted threshold of €50 000, but need to be confirmed with larger samples.},
  author       = {Kobelt, G and Eberhardt, Kerstin and Geborek, Pierre},
  issn         = {1468-2060},
  language     = {eng},
  number       = {1},
  pages        = {4--10},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {TNF inhibitors in the treatment of rheumatoid arthritis in clinical practice: costs and outcomes in a follow up study of patients with RA treated with etanercept or infliximab in southern Sweden.},
  url          = {http://dx.doi.org/10.1136/ard.2003.010629},
  volume       = {63},
  year         = {2004},
}