HEALTH ECONOMIC ASSESSMENT OF ANTIRHEUMATIC DRUGS IN PATIENTS WITH REUMATHOID ARTHRITIS PROGRESSED AFTER METOTREXATE
Abstract
Objective. To perform health economic evaluation of several antirheumatic drugs in patients with rheumatoid arthritis (RA) progressed after DMARDs.
Materials and methods. Three consequent line of rheumatoid arthritis therapy in patients progressed after methotrexate were modeled in Russian economic conditions. Markov modelling and CEA accounting for direct medical costs were used. The effectiveness criteria of RA treatment were: patient-years in remission and patient-years in low disease activity. We compared 12 different treatment regimens of second, third and fourth therapy line in patients progressed after methotrexate.
Results. The health economic analysis of different RA treatment regimen after progression on methotrexate showed that evaluated regimens do not differs in terms of effectiveness and safety. At the mean time the model account for the patients compliance and showed that the maximum number of patient-years in remission can be reached with etanercept and tofacitinib treatment. Moreover, above mentioned combination in comparison to adalimumab and infliximab showed the positive budget impact.
Conclusion. The choice of etanercept and tofacitinib in case of similar economics should be done accounting for individual patient features.
About the Authors
A. S. Kolbin
The first St. Petersburg State Medical University named after Academician Pavlov
Saint Petersburg State University
Russian Federation
Russian Federation
MD, professor, head of department of clinical pharmacology and evidence-based medicine, First St. Petersburg State Medical University. address: ul. L’va Tolstogo, 6-8, St. Petersburg, Russia, 197022; Professor of the Department of Farmakology of St. Petersburg State University. address: 21-Line, 8, VO, St. Petersburg, Russia, 199106. Tel.: +7(812)3386685
A. A. Kurylev
The first St. Petersburg State Medical University named after Academician Pavlov
Russian Federation
Russian Federation
assistant of the Department of clinical pharmacology and evidence-based medicine, The first St. Petersburg State Medical University named after Academician Pavlov. Address: ul. Lva Tolstogo, 6-8, St. Petersburg, Russia, 197022
M. A. Proskurin
Saint Petersburg State University
Russian Federation
Russian Federation
researcher, Saint-Petersburg State University. address: Universitetskii pr., 35, Saint-Petersburg, Russia, 198504. Tel.: +7(812)4287159
Yu. E. Balykina
Saint Petersburg State University
Russian Federation
PhD, senior lecturer, Saint-Petersburg State University, Saint-Petersburg. address: 198504, Universitetskii pr., 35. Tel.: +7(812)4287159
Russian Federation
PhD, senior lecturer, Saint-Petersburg State University, Saint-Petersburg. address: 198504, Universitetskii pr., 35. Tel.: +7(812)4287159
References
1. State Register of marginal cost prices [Gosudarstvennyi reestr predel’nykh otpusknykh tsen (in Russian)]. http://grls.rosminzdrav.ru/pricelims.aspx. Accessed: 12.01.2016.
2. Kulikov A. Y u., Mokhireva L.V., Sorokovnikov I. V. et al. Tuberkulez i bolezni legkikh. 2012; 11: 62-69.
3. The Ministry of Health of the Russian Federation. Order №163 from 27.05.2011. The industry standard clinico-economic study. General 91500.14.0001-2002 [Ministerstvo Zdravookhraneniya Rossiiskoi Federatsii. Prikaz №163 ot 27.05.2011. Otraslevoi standart kliniko-ekonomicheskogo issledovaniya. Obshchie polozheniya 91500.14.0001- 2002 (in Russian)].
4. Nasonov E. L . i soavt. Clinical guidelines. Rheumatoid arthritis. 2013. [Klinicheskie rekomendatsii. Revmatoidnyi artrit (in Russian)]. 2013 g. http://rheumatolog.ru/sites/default/files/Pdf/clinrec/revmatoidnyy_artrit.doc. Accessed: 12.01.2016.
5. H ealth Technology Assessment, Recommendation. Edited by JB Belousov [Otsenka meditsinskikh tekhnologii, Rekomendatsii. Pod obshchei redaktsiei Yu. B. Belousova (in Russian)]. Moscow. 2013; 40 s.
6. Order of the Ministry of Health of the Russian Federation №1470n «On approval of the standard of primary health care to patients with rheumatoid arthritis» from 12.24.12. [Prikaz Ministerstva Zdravookhraneniya RF №1470n «Ob utverzhdenii standarta pervichno mediko-sanitarnoi pomoshchi bol’nym revmatoidnym artritom» ot 24.12.12 (in Russian)]. Accessed: 12.01.2016.
7. Rheumatology: national leadership. Ed. EL Nasonov [Revmatologiya: natsional’noe rukovodstvo. Pod red. E. L. Nasonova (in Russian)]. M. 2010; 720 s.
8. Blumenauer B., Judd M., Wells G., et al. Infliximab for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2002; 3: CD003785.
9. Maxwell L. J., Singh J. A. Abatacept for rheumatoid arthritis. J Rheumatol. 2010; 37 (2): 234-45.
10. Moots R. et al. Burden of Dose Escalation with Biologics in Rheumatoid Arthritis: A Review of Frequency and Costs. ISPOR EU 2013.
11. Nam J. L ., Villeneuve E., Hensor E. M. et al. A randomised controlled trial of etanercept and methotrexate to induce remission in early inflammatory arthritis: the EMPIRE trial. Ann Rheum Dis. 2014; 73 (6): 1027-36.
12. Navarro-Sarabia F., Ariza-Ariza R., Hernández-Cruz B., et al. Adalimumab for treating rheumatoid arthritis. J Rheumatol. 2006; 33 (6): 1075-81.
13. Ruiz Garcia V., Jobanputra P., Burls A. et al. Certolizumab pegol (CDP870) for rheumatoid arthritis in adults. Cochrane Database Syst Rev. 2014; 9: CD007649.
14. Scott L. J. Tofacitinib: a review of its use in adult patients with rheumatoid arthritis. Drugs. 2013; 73 (8): 857-74.
15. Singh J. A., Furst D. E ., Bharat A. et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012; 64 (5): 625-39.
16. Smolen J. S., Landewé R., Breedveld F. C., et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014; 73 (3): 492-509.
Review
For citations:
Kolbin A.S., Kurylev A.A., Proskurin M.A., Balykina Yu.E. HEALTH ECONOMIC ASSESSMENT OF ANTIRHEUMATIC DRUGS IN PATIENTS WITH REUMATHOID ARTHRITIS PROGRESSED AFTER METOTREXATE. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2016;9(3):20-28. (In Russ.) https://doi.org/10.17749/2070-4909.2016.9.3.020-028
Views: 872
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 