PMID- 30072903
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 9
DP  - 2018
TI  - Quality of Life and Cost Study of Rheumatoid Arthritis Therapy With Biological 
      Medicines.
PG  - 794
LID - 10.3389/fphar.2018.00794 [doi]
LID - 794
AB  - Biological medicines are considered as a cornerstone in the therapy of rheumatoid 
      arthritis (RA). They change the course of the disease and improve the quality of 
      life of patients. To this date there has been no study comparing the quality of 
      life of and cost of RA therapy in Bulgaria. This fact is what provoked our 
      interest toward this research. The aim of this study is to analyse the cost and 
      quality of life of patients with RA threated with biological medicines in 
      Bulgaria. This is an observational, real life study of 124 patients treated with 
      biological medicines during 2012-2016 at the University hospital "St. Ivan 
      Riskli" in Sofia, specialized in rheumatology disease therapy. Patients were 
      recruited after their consecutive transfer from non-biological to biological 
      medicines. The yearly pharmacotherapy cost was calculated with tocilizumab (n = 
      30), cetrolizmab (n = 16), golimumab (n = 22), etanercept (n = 20), adalimumab (n 
      = 20), rituximab (n = 16). Three measurements of the quality of life (QoL) were 
      performed with EQ5D-at the beginning of the therapy, after 6 months and after 1 
      year of therapy. Both section of EQ5D were used-VAS and EQ5D questionnaire. 
      Cost-effectiveness was calculated for unit of improvement in EQ5D score for a one 
      year period and decision model was built with TreeAgePro software. The observed 
      cost of therapy varied between 12 thousand Euros for tocilizumab to 6 thousand 
      Euros for rituximab. All biological medicines let to substantial increase in the 
      quality of life of the patients. Patients on tocilizumab increased their QoL from 
      0.43 to 0.63 after 1 year; on cetrolizumab from 0.32 to 0.56; on golimumab from 
      0.41 to 0.67; on etanercept from 0.45 to 0.62; on adalimumab from 0.43 to 0.57; 
      on rhituximab from 0.46 to 0.66. The cost-effectiveness estimates of different 
      biological therapies also varied between 66 to 30 thousand Euros for unit of 
      improvement in the EQ5D during one the course of the year. Therapy with 
      biological medicines improves statistically significant the quality of life of 
      patients, measured through VAS and EQ5D scales. Despite the improvement in the 
      quality of life all biological medicines appears not to be note cost-effective 
      due to their high incremental cost-effectiveness ration (ICER). Rituximab's 
      incremental ratio has (ICER) falls closer to the three times gross domestic 
      product per capita threshold and should be considered as preferred alternatives 
      for RA therapy. In general we can conclude that the treatment of rheumatoid 
      arthritis with biologicals improves quality of life significantly. Only rituximab 
      was cost-effective.
FAU - Boyadzieva, Vladimira V
AU  - Boyadzieva VV
AD  - Faculty of Medicine, University Hospital St. Ivan Rilski, Medical University of 
      Sofia, Sofia, Bulgaria.
FAU - Stoilov, Nikolay
AU  - Stoilov N
AD  - Faculty of Medicine, University Hospital St. Ivan Rilski, Medical University of 
      Sofia, Sofia, Bulgaria.
FAU - Stoilov, Rumen M
AU  - Stoilov RM
AD  - Faculty of Medicine, University Hospital St. Ivan Rilski, Medical University of 
      Sofia, Sofia, Bulgaria.
FAU - Tachkov, Konstantin
AU  - Tachkov K
AD  - Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria.
FAU - Kamusheva, Maria
AU  - Kamusheva M
AD  - Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria.
FAU - Mitov, Konstantin
AU  - Mitov K
AD  - Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria.
FAU - Petrova, Guenka I
AU  - Petrova GI
AD  - Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria.
LA  - eng
PT  - Journal Article
DEP - 20180718
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC6058036
OTO - NOTNLM
OT  - EQ5D
OT  - Rheumatoid arthritis
OT  - biological therapy
OT  - cost-effectiveness
OT  - quality of life
EDAT- 2018/08/04 06:00
MHDA- 2018/08/04 06:01
PMCR- 2018/07/18
CRDT- 2018/08/04 06:00
PHST- 2018/04/07 00:00 [received]
PHST- 2018/06/29 00:00 [accepted]
PHST- 2018/08/04 06:00 [entrez]
PHST- 2018/08/04 06:00 [pubmed]
PHST- 2018/08/04 06:01 [medline]
PHST- 2018/07/18 00:00 [pmc-release]
AID - 10.3389/fphar.2018.00794 [doi]
PST - epublish
SO  - Front Pharmacol. 2018 Jul 18;9:794. doi: 10.3389/fphar.2018.00794. eCollection 
      2018.