Background The EULAR and ACR guidelines do not recommend any biological treatment above another in terms of efficacy. Thus financial aspects, such as the real associated cost, should be taken into account so that patients are offered the more efficient treatment and the best use is made of health resources.
Purpose To analyse dose patterns and associated costs per patient per year (PPPY) of etanercept (ETN), adalimumab (ADA) and infliximab (IFX) in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients in clinical practice.
Materials and methods An observational transversal study was performed including all patients with RA, PsA or AS treated with ETN, ADA or IFX for at least 6 months between January 2008 and April 2013.
Administered doses were calculated using individual claims data according to Pharmacy Department’ records, standardised and adjusted to a mean percentage of SmPC recommended doses (considered as 100%).
Temporary interruptions were taken into account.
Annual (52 weeks) costs were calculated using the Spanish ex-factory unitary prices of each agent: 494.6 € for 40 mg adalimumab, 227.8 € for 50 mg etanercept and 515.9 € for 100 mg infliximab, including tax (2013 €).
Results 451 patients were included (49.9% RA; 26.6% AS; 23.5% PsA). Anti-TNF distribution was: etanercept 37.5%; adalimumab 32.6%; infliximab 29.9%.
Dose, associated costs and suspension of treatment are shown in the table:
Similar results of antiTNF use in clinical practice have been already presented ,.
Conclusions The optimization of biological agents in certain clinically stable patients reduces mean administered doses and associated costs below the recommended ones, a trend not observed with infliximab.
The average cost PPPY associated with etanercept was significantly lower than that of adalimumab and infliximab.
Ramírez-Herráiz E, et al. Efficiency of adalimumab, etanercept and infliximab in rheumatoid arthritis patients: dosing patterns and effectiveness in daily clinical practice. Clin Exp Rheumatol 2013 Jul-Aug;31(4):559-65. Epub 2013 May 27
De la Torre, I, et al. Anti-TNF treatments in rheumatoid arthritis: economic impact of dosage modification. Expert Rev Pharmacoecon Outcomes Res 2013;13(3):407–414
No conflict of interest.
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