Dose modification of anti-TNF in rheumatoid arthritis and estimated economical impact: a review of observational studies

Abstract

Anti-TNF drugs indicated for the treatment of moderate-to-severe active rheumatoid arthritis (RA) presents similar efficacy, safety and potential toxicity profiles, with more than 10 years’ treatment experience. Several pharmacoeconomic evaluations had demonstrated their favorable cost–effectiveness profile in RA patients, based on pivotal clinical studies data from different countries and perspectives. However, in clinical practice, individual profiles of patients and drugs leads to dose modifications that may be associated with substantial cost deviations. Here, we further discuss the effect of dose titration of these biological drugs in clinical practice over their RA cost–effectiveness profiles.

Keywords:

• adalimumab
• anti-TNF
• cost–effectiveness
• dose modification
• etanercept
• infliximab
• real-world data
• rheumatoid arthritis

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The use of biological drugs have demonstrated greater efficacy than conventional therapies, but tripled the direct costs of rheumatoid arthritis.

• There are no significant differences between biological treatments in their clinical response.

• In clinical practice, dose optimizations have been observed over time in some rheumatoid arthritis biological drugs and have important economic impact.

• Real-world drug cost information is key to make more cost-effective decisions.