Cost Effectiveness of TNF-αInhibitors in Rheumatoid Arthritis

Abstract

Background. TNF-α inhibitors have shown to be effective in reducing disease activity and improving the quality of life. Due to the high costs associated with acquisition of this treatment, this study was undertaken to evaluate the ICER of TNF-α antagonists (etanercept, adalimumab, and infliximab) in improving the quality of life. Methods. The HAQ and SF-36 were administered at phases 1, 2, and 3, in order to assess the improvement in the QOL. Suppression of disease activity was assessed through the DAS-28. Results. Statistically significant improvements (P < 0.05) were noted for the SF-36 and HAQ after 3 months and for the DAS-28 after 6 months of TNF-α inhibitor therapy. The mean ICER per 10% improvement in the HAQ, DAS-28, and SF-6D were €1976.5, €2086.5, and €2316.4, respectively, following 6 months of TNF-α intervention. Most favorable ICERs were reported from a patient who had to undergo surgical intervention whilst on DMARD therapy. Conclusion. Significant improvement was observed in patients' quality of life, after a short timeframe of 6 months. Such data is useful information in the light of convincing policy makers, in terms of providing access to the medications to individual patients on national health service schemes.

Antitumor Necrosis Factor-like Ligand 1A Therapy Targets Tissue Inflammation and Fibrosis Pathways and Reduces Gut Pathobionts in Ulcerative Colitis

“…Studies show that both adherent-invasive Escherichia coli and H. parainfluenzae are increased in participants with active IBD and may contribute mechanistically to the inflammatory response. 37 In addition, oral microbes including Haemophilus 38 and Streptococcus subspecies show increased colonization during IBD and may contribute to an inflammatory immune response. 39 In contrast, strict anaerobic metabolism is reflected in the pathways of bacteria, including Ruminococcus and Bifidobacterium , associated with health, such as the production of short-chain fatty acids.…”

Reduction in the utilization of prednisone or methotrexate in Canadian claims data following initiation of etanercept in pediatric patients with juvenile idiopathic arthritis

“…Pediatric patients with JIA who have not responded to conventional DMARDs such as MTX, and who subsequently benefit from treatment with TNF inhibitors, are likely to have improvements in quality of life [35, 43–45]. Although TNF inhibitors are more expensive than steroids or synthetic DMARDs, clear benefits are gained in quality of life, increases in productivity, and reductions in healthcare utilization, at least in the adult population [46–48]. Formal cost-effectiveness assessments of TNF inhibitors in pediatric JIA patients have shown that switching inadequate responders or non-responders from MTX treatment is associated with better short-term outcomes but at a relatively high cost per quality-adjusted life year (QALY) [35, 43–45].…”

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“…TNF inhibitors are expensive as well as increases the burden of RA patient but Said Cynthia in his research, has revealed that in the short term of 6 months, the patient's quality of life increases and so, the pharmacoeconomic impact also increases eventually 56 . Prior to start with TNF inhibitors, therapy patient should be screened for latent tuberculosis and other preexisting infections.…”