Anti-TNF treatments in rheumatoid arthritis: economic impact of dosage modification

Abstract

Rheumatoid arthritis (RA) is a chronic systemic disease that leads to increases in health system economic burden through direct and indirect costs, including chronic treatment, reduced productivity and premature mortality. Anti-TNF agents have represented a major advance in the treatment of RA. The most commonly used (adalimumab, etanercept and infliximab) have demonstrated their cost–effectiveness at label doses. However, physicians may need to adapt the treatment by increasing the dose when a drug is not effective enough or by reducing it when there is a sustained effectiveness. In a cross-sectional study conducted in our hospital in which information from RA patients treated with anti-TNF drugs under conventional and modified doses were collected, the authors analyzed the costs of the medication in order to estimate the mean patient-year cost, the annual costs related to clinical efficacy and the cost per responder patient to anti-TNF treatment when dosage modification is undertaken in daily clinical practice.

Keywords::

• adalimumab
• anti-TNF drugs
• clinical practice
• etanercept
• infliximab
• modified doses
• patient-year cost
• rheumatoid arthritis

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Erratum

Acknowledgements

The authors wish to thank the Instituto de Investigacion Biomedica, Hospital General Universitario Gregorio Marañón (Madrid, Spain), for supporting the clinical and basic investigation in the department.

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 apart from those disclosed.

Editorial/medical writing support was provided by Pablo Pons from Content Ed Net and was funded by Pfizer.