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Medico-economic evaluation of infliximab in rheumatoid arthritis--prospective French study of a cohort of 635 patients monitored for two years.
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2009 Oct; Vol. 48 (10), pp. 1236-41. Date of Electronic Publication: 2009 Jul 20. - Publication Year :
- 2009
-
Abstract
- Objectives: To perform, in real conditions of prescription, the medico-economic evaluation of infliximab in severe RA.<br />Methods: A cost-effectiveness analysis of the annual costs was done with a comparison between the previous and the following year under infliximab. The effectiveness, determined from the HAQ, was expressed in clinically significant units and in quality-adjusted life years (QALYs). The incremental net benefit (INB), defined as willingness to pay (lambda), was used to express the results.<br />Results: A cohort of 635 patients was formed. Before the use of infliximab, after 1 and 2 years, the mean annual cost per patient for the care of RA was 9832, 27,723 and 46,704 euro, respectively. Among the direct costs, infliximab accounts for 21,182 euro for the first year. The distribution of the different costs was similar after 2 years. By using the INB, the difference before and after 1 year under infliximab is significant, on average by 1.86 (S.E.M. = 0.76) when the effectiveness is expressed in clinically significant units. For severe HAQ, lambda is 9841 euro (18,593 for all HAQ). When it is expressed in QALYs, also for severe HAQ, lambda > 100,000 euro. This can be explained by a short follow-up although severe complication of RA appears later.<br />Conclusion: An evaluation of the more long-term costs is required in order to determine whether there are any full economic benefits with this treatment.
- Subjects :
- Adult
Aged
Antibodies, Monoclonal therapeutic use
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid drug therapy
Cost of Illness
Cost-Benefit Analysis
Drug Costs statistics & numerical data
Epidemiologic Methods
Female
France
Health Care Costs statistics & numerical data
Humans
Infliximab
Male
Middle Aged
Treatment Outcome
Tumor Necrosis Factor-alpha antagonists & inhibitors
Antibodies, Monoclonal economics
Antirheumatic Agents economics
Arthritis, Rheumatoid economics
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 48
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 19620209
- Full Text :
- https://doi.org/10.1093/rheumatology/kep198