A review of cost–effectiveness evaluations as part of national health technology assessments of biologic DMARDs in the treatment of rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is an autoimmune chronic disease which is associated with an increasing disability in patients and high socioeconomic burden. Given the large number of economic evaluations considered by national health technology assessments (HTAs), this review attempts to clarify whether results from biologic disease-modifying antirheumatic drugs (DMARDs) economic evaluations form the basis of official recommendation by national HTA agencies in Australia, Canada, Scotland and England. The results show that evidence of cost–effectiveness was not equally perceived by decision makers and did not have equal weightage in defining the official listing of biologic DMARDs for the treatment of RA. As it has been demonstrated in previous studies, major barriers exist for the integration of cost–effectiveness and cost-utility results with national HTA activity. In fact, as shown in this review, even when such analysis are available, cost-minimization and comparative effectiveness studies seemed to be preferred by some HTA agencies as tools to inform allocation of healthcare resources.

Keywords::

• cost–effectiveness
• cost-utility
• high disease burden
• national HTA agencies
• novel biologic disease-modifying antirheumatic drugs
• official drug recommendations
• older anti-TNF-α agents
• rheumatoid arthritis

Financial & competing interests disclosure

S Iannazzo, M De Francesco and D Gomez-Ulloa are employees of IMS RWE Solutions & HEOR. MSD Italia Spa (Rome, Italy) supported the development of the study but was not involved in the production of the manuscript. The authors have no other 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.

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

Appendix A

Documents which did not fulfill inclusion criteria and were therefore excluded from the review.

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