PMID- 12491120
OWN - NLM
STAT- MEDLINE
DCOM- 20090819
LR  - 20021219
IS  - 1435-1250 (Electronic)
IS  - 0340-1855 (Linking)
VI  - 61 Suppl 2
DP  - 2002
TI  - [Current aspects of cost effectiveness of TNF-alpha blocking agents in patients 
      with rheumatoid arthritis].
PG  - II/29-32
AB  - Facing increasing health-related costs and limited health care resources, the 
      assessment of cost effectiveness (CE) of medical procedures is also gaining 
      considerable importance in the field of rheumatology. Since high annual therapy 
      costs of 17,000-21,000 Euro are related to the employment of TNF-alpha blocking 
      agents such as etanercept and infliximab (compared to annual costs of 350-5000 
      Euro of other disease modifying drugs (DMARDs) in the treatment of rheumatoid 
      arthritis (RA)), their CE has become an important issue. The present 
      investigation summarizes economic evaluations of cost and effectiveness of 
      TNF-alpha blocking agents and compares the results to those of traditional DMARD 
      therapies in patients with RA. The implications of these economic results on the 
      further use of TNF-alpha blocking drugs and methodological improvements of their 
      economic evaluation are discussed. The current literature provides evidence for 
      the CE of the combination therapy with methotrexate (MTX), hydroxychloroquine 
      (HCQ), and sulfasalazine (SASP). In comparison to this finding, the use of 
      etanercept and MTX yields much higher costs, although the highest rate of ACR20 
      responses is achieved by this combination (additional costs of $42,000 per ACR20 
      response compared to combination of MTX, HCQ, and SASP). Two recent studies show 
      more promising results of about $12,000/QUALY and even cost savings per QUALY 
      administering etanercept and infliximab, respectively. The wide range of the CE 
      ratios is mainly explained by different methodological approaches. Whether the 
      wider employment of TNF-alpha blocking drugs (comprising not only selected 
      patients) proves to be economically effective, remains to be investigated by 
      further economic analyses. In contrast to the initial disappointing results of 
      the comparison of established DMARD therapies and TNF-alpha blocking drugs in 
      terms of CE, recently published data renders evidence that the CE of the 
      TNF-alpha blocking drugs is comparable to other accepted therapies in internal 
      medicine.
FAU - Merkesdal, Sonja
AU  - Merkesdal S
AD  - Medizinische Hochschule Hannover, Abt. Rheumatologie, Carl-Neuberg-Str. 1, 30625 
      Hannover, Germany.
FAU - Ruof, J
AU  - Ruof J
LA  - ger
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Betrachtungen zur Kosteneffektivitat der Therapie mit TNF-alpha blockierenden 
      Substanzen bei Patienten mit chronischer Polyarthritis.
PL  - Germany
TA  - Z Rheumatol
JT  - Zeitschrift fur Rheumatologie
JID - 0414162
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Anti-Inflammatory Agents/*economics/*therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy/*economics/epidemiology
MH  - Cost-Benefit Analysis
MH  - Germany/epidemiology
MH  - Health Care Costs
MH  - Humans
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
RF  - 6
EDAT- 2002/12/20 04:00
MHDA- 2009/08/20 09:00
CRDT- 2002/12/20 04:00
PHST- 2002/12/20 04:00 [pubmed]
PHST- 2009/08/20 09:00 [medline]
PHST- 2002/12/20 04:00 [entrez]
AID - 10.1007/s00393-002-1207-7 [doi]
PST - ppublish
SO  - Z Rheumatol. 2002;61 Suppl 2:II/29-32. doi: 10.1007/s00393-002-1207-7.