期刊
RHEUMATOLOGY
卷 50, 期 7, 页码 1320-1330出版社
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/ker084
关键词
Rheumatoid arthritis; Combination drug therapy; Therapeutic use; Cost-effectiveness analysis; Remission induction
类别
资金
- Wyeth Pharmaceuticals
- Dutch National Health Insurance Board
- Dutch affiliations of Wyeth Pharmaceuticals
- Abbott Pharmaceuticals
- Schering-Plough Corporation
- Roche Pharmaceuticals
- Bristol-Myers Squibb
- MSD
- Wyeth
- Abbott
- Roche
- BMS
Methods. A validated Markov model was used to evaluate the cost-effectiveness of the three strategies. Effectiveness of the strategies was determined using daily practice data from two cohorts and used as input parameter in the model. Patients treated according to the strategies were matched for baseline 28-joint DAS (DAS-28). Using Monte Carlo simulation, expected costs, quality-adjusted life-years (QALYs) and incremental cost per QALY gained for a 5-year time horizon were calculated following both a health-care and a societal perspective. Results. The percentage of patients in remission and number of QALYs were comparable between the three strategies. Starting with a combination (MTX plus LEF or anti-TNF) was more costly than starting with MTX alone. This resulted in an unfavourable incremental cost-effectiveness ratio for starting on anti-TNF vs initially MTX: health-care perspective of euro138 028 and from a societal perspective of euro136 150 per QALY gained over 5 years. Conclusion. In this modelling study, starting with MTX or anti-TNF has comparable effectiveness. However, initial anti-TNF was far more expensive than starting with MTX monotherapy. Therefore, based on this study, a treatment strategy starting with MTX monotherapy is favoured over a strategy with MTX and anti-TNF right away in early RA patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据