CONTROLLING THE COST SPENT ON EXPENSIVE BIOLOGIC AGENTS- AN EXAMPLE OF NET MONETARY SAVINGS BY DOSE OPTIMISATION OF TUMOR NECROSIS FACTOR INHIBITORS IN RHEUMATOID ARTHRITIS PATIENTS
Author(s)
Kievit W1, van Herwaarden N2, van den Hoogen F2, van Vollenhoven R3, Bijlsma H4, van den Bemt B2, van der Maas A2, den Broeder A2
1Radboudumc, Nijmegen, The Netherlands, 2Sint Maartenskliniek, Nijmegen, The Netherlands, 3Karolinska University Hospital, Stockholm, Sweden, 4Utrecht Univeristy Medical Centre, Utrecht, The Netherlands
OBJECTIVES: Effective but expensive (approximately €14,000 per year) tumor necrosis factor inhibiting drugs (TNFi) are used for the treatment of several chronic inflammatory diseases including rheumatoid arthritis (RA). A proven dose reduction strategy in RA patients could result in substantial cost savings. It may however also lead to a loss of quality of life as a result of flares induced by dose reduction attempts. If this loss is compensated with large cost saving, we might still consider the intervention cost-effective. METHODS: a pre-planned cost-effectiveness analysis of the DRESS study, a randomised controlled, non-inferiority trial comparing a disease activity guided dose optimisation strategy with usual care in patients with RA and low disease activity using TNFi. Total health care costs were measured and quality adjusted life years (QALY) were based on EQ5d utilities. Decremental cost-effectiveness ratio and incremental net monetary benefit (iNMB) were determined. Bootstrap analyses with 1000 replications were used. RESULTS:
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PMS79
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Musculoskeletal Disorders