Cost–effectiveness of tumor necrosis factor-α antagonists in rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

Abstract

The treatment of chronic arthritic diseases has undergone some dramatic changes over the past few years. In particular, a new class of drugs called the tumor necrosis factor-α antagonists has transformed the management of rheumatoid arthritis, and decision makers are now consid1ering their use in psoriatic arthritis and ankylosing spondylitis. Whilst short-term clinical trials suggest that tumor necrosis factor-α antagonists improve physical function and pain linked to disease activity, this class of drug has generated controversy owing to its substantial cost. Pharmacoeconomic studies conclude that tumor necrosis factor-α antagonists result in significant increases in health-related quality of life; however, the cost–effectiveness of this class of drug remains uncertain, particularly in the treatment of psoriatic arthritis and ankylosing spondylitis. This paper reviews pharmacoeconomic analyses examining the cost–effectiveness of tumor necrosis factor-α inhibitors in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis.

Keywords::

• adalimumab
• ankylosing spondylitis
• biological response modifier
• cost–effectiveness analysis
• etanercept
• infliximab
• psoriatic arthritis
• rheumatoid arthritis