Background The use of biological drugs such as tocilizumab for rheumatoid arthritis (RA) is very expensive. However, some observational studies and recommendations from guidelines (BBF) suggest the possibility of reducing the dose of biologicals to the minimum effective dose in patients with good control of the disease.
Purpose To assess the financial impact, measured as direct costs, of the use of reduced doses of tocilizumab for the treatment of RA in a tertiary hospital.
Material and methods Observational, descriptive and retrospective study with patients diagnosed with RA. We included patients who received low doses of tocilizumab, because they had achieved remission or low disease activity with standard doses of tocilizumab (8 mg/kg every 28 days).
Results 7 patients were included, all of them treated with tocilizumab 6 mg/kg every 28 days. The average weight was 75 kg (55–100). The average annual cost per patient with a dose of 6 mg/kg every 28 days was €9,394 (6,647–13,899). The average annual cost for the same patient in the previous year, with doses of 8 mg/kg every 28 days, had been €12,178 (8,863–16,115). The average saving per patient/year was €2,784 (2,215–3,939). The use of reduced doses of tocilizumab for these 7 patients resulted in annual savings for the hospital of €19,490.
Conclusion Reducing the dose of tocilizumab in patients who have achieved remission or low disease activity having previously been treated with standard doses of tocilizumab provided direct savings for the hospital. Therefore, we are aware of the need to implement optimisation strategies in relation to the treatment of RA with tocilizumab in selected patients. However, more studies should be performed in order to determine the effectiveness of these dose reduction strategies and their financial impact on both direct and indirect costs.
References and/or Acknowledgements No conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.