Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation

Abstract

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Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for the treatment of rheumatoid arthritis not previously treated with disease-modifying antirheumatic drugs and after the failure of conventional disease-modifying antirheumatic drugs only: systematic review and economic evaluation

“…This review differed from other reviews of biologics in RA, 123, [161][162][163][164][165][166][167][168][169][170][171][172] in that it included only licensed doses of biologics, was limited to first-line biologics, and considered separately MTX-naive and cDMARD-experienced trials.…”

The clinical effectiveness and cost-effectiveness of abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis: a systematic review and economic evaluation

“…Of the six TA publications available on the NICE website, [154][155][156][157][158][159] only one contained data for the cost of an AE, namely TA195: Adalimumab, Etanercept, Infliximab, Rituximab and Abatacept for the Treatment of Rheumatoid Arthritis after the Failure of a TNF Inhibitor. 158 A Pfizer CS provided the only relevant cost data in TA195. Pfizer assumed that a SAE involved two general practitioner visits, 7 days of hospitalisation and a utility decrement of 0.05, with a total cost of £1181.…”

Cost-effectiveness of biologic treatment for rheumatoid arthritis in clinical practice: An achievable target?

“…On the other hand, at a willingness-to-pay threshold of Can $100,000 per QALY gain, the results may be outlined thus: 1) the use of biologics in patients who have not previously undergone traditional DMARD treatment is only slightly cost-effective; 2) in patients in whom MTX in mono-therapy was not effective, the use of biologics was cost-effective; 3) in patients who had no response to treatment with MTX in combination with (an)other DMARD(s), introduction of the biologic drug into the treatment programme was costeffective in 14 out of 35 comparisons. As regards other biologic drugs used in the treatment of rheumatoid arthritis, abatacept has been estimated to be cost-effective from the societal perspective in patients who do not respond to MTX and/or to the first TNFα inhibitor [42], [43], [44] and [45]. This is also true for rituximab when it is utilised in patients who fail to respond to the first TNFα, compared to another anti TNFα or a sequence of TNF inhibitors [43], [44], [45] and [46].…”

“…As regards other biologic drugs used in the treatment of rheumatoid arthritis, abatacept has been estimated to be cost-effective from the societal perspective in patients who do not respond to MTX and/or to the first TNFα inhibitor [42], [43], [44] and [45]. This is also true for rituximab when it is utilised in patients who fail to respond to the first TNFα, compared to another anti TNFα or a sequence of TNF inhibitors [43], [44], [45] and [46]. Rituximab seems to be the most costeffective second line biologic drug [43], [44], [47] and [48].…”

“…This is also true for rituximab when it is utilised in patients who fail to respond to the first TNFα, compared to another anti TNFα or a sequence of TNF inhibitors [43], [44], [45] and [46]. Rituximab seems to be the most costeffective second line biologic drug [43], [44], [47] and [48]. A recent analysis has demonstrated that the use of tocilizumab is cost-effective if given after the failure of another biological DMARD or as an addition to the current standard of care in the treatment of RA with an inadequate response to DMARDs [49].…”