OBJECTIVES: This study examines comparators used for biologic Rheumatoid Arthritis (RA) drugs, both Tumor Necrosis Factor (TNF) drugs and Disease-Modifying, Anti-Rheumatic Drugs (DMARDs), and the decision compared to the European label. The change in comparator categories for RA drugs over time is also assessed. METHODS: This research highlights RA Health Technology Assessments (HTAs), published from 2005 – 2014, from NICE, SMC, HIS, HAS, and IQWiG. (The G-BA did not review RA during this time frame.) Comparators were split into two non-mutually-exclusive categories: comparators that included methotrexate, and comparators that included DMARDs. Comparators that included methotrexate were separated into: methotrexate alone, or methotrexate with other drugs. Comparators that included DMARDs were split into: biologics alone, biologics plus methotrexate, and conventional DMARDs (no biologics). By matching on indication and time, and restricting against the European label, HTA decisions were determined to be either: Recommend, Recommend With Restrictions (RWR), Do Not Recommend (DNR), or No Decision. RESULTS: The sample included 77 reviews. Twenty-two reviews used methotrexate in combination with biologic drugs as comparators. Of these, 13 (59%) received a Recommend, six (27%) received RWR, and three (14%) were DNR. The frequency of the use of biologics (alone or in combination) as comparators increased each year between 2006, with 14%  (1/7), and 2009, with 60% (3/5). In 2009, one (20%) of the five reviews was the first to use a biologic exclusively as a comparator, and received a decision of Recommend. In 2013, two (13%) of the 15 reviews used biologics only, and received No Decision. In 2014, all two (100%) of the reviews used biologics alone as comparators, with one receiving a decision of Recommend, and the other RWR. CONCLUSIONS: While the categories of comparators used in RA varied over time, the increased use of biologics in recent years illustrates a steady trend.