Cost-effectiveness of clinical remission by treat to target strategy in established rheumatoid arthritis: results of the CREATE registry

Rheumatol Int. 2016 Dec;36(12):1627-1632. doi: 10.1007/s00296-016-3583-3. Epub 2016 Oct 24.

Abstract

To analyse the cost-effectiveness, in daily clinical practice, of the strategy of treating to the target of clinical remission (CR) in patients with established rheumatoid arthritis (RA), after 2 years of treatment with biological therapy. Adult patients with established RA were treated with biological therapy and followed up for 2 years by a multidisciplinary team responsible for their clinical management. Treatment effectiveness was evaluated by the DAS28 score. The direct costs incurred during this period were quantified from the perspective of the healthcare system. We calculated the cost-effectiveness of obtaining a DAS28 < 2.6, considered as CR. The study included 144 RA patients treated with biological therapies. After 2 years of treatment, 32.6% of patients achieved CR. The mean cost of achieving CR at 2 years was 79,681 ± 38,880 euros. The strategy of treatment to the target of CR is considered the most effective, but in actual clinical practice in patients with established RA, it has a high cost.

Keywords: Biological drugs; Clinical remission; Cost-effectiveness; Real clinical practice; Rheumatoid arthritis; Treat to target.

MeSH terms

  • Adult
  • Antirheumatic Agents / economics*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / economics
  • Biological Products / economics*
  • Biological Products / therapeutic use
  • Cost-Benefit Analysis*
  • Databases, Factual
  • Female
  • Health Care Costs
  • Humans
  • Male
  • Methotrexate / economics
  • Methotrexate / therapeutic use
  • Middle Aged
  • Remission Induction
  • Severity of Illness Index
  • Sulfasalazine / economics
  • Sulfasalazine / therapeutic use
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Biological Products
  • Sulfasalazine
  • Methotrexate