1. Cost-utility analysis of the anti-TNF therapy for rheumatoid arthritis in a real-world based model.
- Author
-
Dos Santos JBR, da Silva MRR, Almeida AM, Acurcio FA, and Alvares-Teodoro J
- Subjects
- Adalimumab administration & dosage, Adalimumab economics, Adult, Aged, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal economics, Antirheumatic Agents economics, Arthritis, Rheumatoid economics, Brazil, Cohort Studies, Cost-Benefit Analysis, Etanercept administration & dosage, Etanercept economics, Female, Follow-Up Studies, Humans, Male, Markov Chains, Middle Aged, Prospective Studies, Tumor Necrosis Factor Inhibitors economics, Antirheumatic Agents administration & dosage, Arthritis, Rheumatoid drug therapy, Models, Economic, Tumor Necrosis Factor Inhibitors administration & dosage
- Abstract
Background: Spending on drugs provided by the Brazilian Public Health System (BPHS) for the treatment of rheumatoid arthritis (RA) increased substantially with the beginning of the supply of biological disease-modifying anti-rheumatic drugs (bDMARD). This study aims to perform a cost-utility analysis of the most used biological drugs for the treatment of RA in Brazil., Methods: a Markov model was used to carry out the cost-utility analysis. The data were obtained from a prospective cohort of RA patients using adalimumab, etanercept, and golimumab in Brazil. The BPHS perspective was adopted and the time horizon was five years. Deterministic and probabilistic sensitivity analyses were performed to evaluate the uncertainty., Results: golimumab was the most cost-effective drug. Etanercept was dominated by golimumab. Adalimumab presented an incremental cost-utility ratio (ICUR) of $95,095.37 compared to golimumab in five years of follow-up. These results were confirmed by sensitivity analyses., Conclusion: the utility among adalimumab, etanercept, and golimumab was similar and the cost was the component that most impacted the economic model. Therefore, depending on the agreed price with the drug manufacturers, the incremental cost-utility ratio may vary among them.
- Published
- 2021
- Full Text
- View/download PDF