OBJECTIVES

: Selecting the right patient for the right treatment with efficient cost is the main goal for effective health system when the prevalence of RA 0.3% in Egypt with characterization of younger age at disease onset, lower frequency of extra articular manifestations, more frequent poly articular pattern at disease onset and less erosive disease,

the previous information might lead to increase of economic burden for Rheumatoid Arthritis for the payer side also the need was raised for Prioritization of treatment lines to achieve previous objectives .

The objective for this study is to determine economic evaluation for Biological treatments vs Disease-modifying anti-rheumatic drugs (DMARDs) reducing economic burden for Rheumatoid Arthritis and enhancement for patients outcomes IN Egypt.

METHODS

Markov model was developed the structure of this model reflects the natural history of RA. The model conforms to real practice of management of RA in Egypt and was validated by experts. No head-to-head trials analyzing the efficacy of Golimumab compared with other active treatment options were available. This leaded to network meta-analysis

Was conducted using a literature search covering Medline, Scopus, Cochrane library, ACP Journal club and Web of Science was performed. Sensitivity analyses were performed for ACR20 and ACR50 responses based on NICE recommendations.

RESULTS

: For early RA and naive to (DMARDs) incremental QALY gained for Golimumab was (1,334.4) QALY vs (1,331.8) QALY for (DMARDs). For inadequate response to (DMARDs) incremental QALY gained for Golimumab was (1, 4 34) QALY vs (1,331.8) QALY. For (DMARDs)

For an inadequate response to at least one TNF inhibitor incremental QALY gained for Golimumab was (1.443.3) QALY vs range (1,331.8 to 1,335 ) QALY for other TNF inhibitor.

CONCLUSION

Using Golimumab as a priority for treatment Rheumatoid Arthritis might have a positive impact for reducing economic burden for disease plus enhancements for patients out comes.