Value of Remission in Patients with Rheumatoid Arthritis: A Targeted Review

Abstract

The treat-to-target strategy, which defines clinical remission as the primary therapeutic goal for rheumatoid arthritis (RA), is a widely recommended treatment approach in clinical guidelines. Achieving remission has been associated with improved clinical outcomes, quality of life, and productivity. These benefits are likely to translate to reduced economic burden in terms of lower healthcare costs and resource utilization. As such, a literature review was conducted to better understand the economic value of remission. Despite the large heterogeneity found in RA-related economic outcomes across studies, patients in remission consistently had lower direct medical and indirect costs, less healthcare resource utilization, and greater productivity compared to those without remission. Remission was associated with 19–52% savings in direct medical costs and 37–75% savings in indirect costs. The economic value of remission should thus be considered in economic analyses of RA therapies to inform treatment and reimbursement decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01946-w.

Analiza przebiegu hospitalizacji pacjentów chorych na reumatoidalne zapalenie stawów w warunkach codziennej praktyki klinicznej

“…Patients admitted outside the therapeutic programme are those admitted for emergency indications, with an exacerbation of the disease. This admission structure reflects trends in RA treatment, based mainly on outpatient care that guarantees a professional and comprehensive approach to the patient, with modification of the treatment if needed [11]. This approach to the management of RA brings our country closer to the standards developed in Western Europe and the United States [12].…”

Remission in Type 2 Inflammatory Diseases: Current Evidence, Unmet Needs, and Suggestions for Defining Remission in Chronic Rhinosinusitis with Nasal Polyps

“…Biological therapy has revolutionized the treatment of many chronic inflammatory diseases, including psoriasis, rheumatoid arthritis, and inflammatory bowel disease, allowing for the development of a “treat-to-target” approach that ultimately aims at achieving and maintaining the target (remission) in many patients [ 6 – 8 ]. In rheumatic diseases, the first definition of remission dates back to 1996 [ 9 ]; later on, with the spread of the treat-to-target strategy, it became evident that the achievement of the target was associated with an improvement in short- and long-term clinical outcomes and patients’ quality of life, with not negligible economic benefits due to less direct and indirect costs for the management of the disease [ 10 ].…”

The Economic Benefit of Remission for Patients with Rheumatoid Arthritis

“…These therapies have been shown to dramatically improve symptoms and quality of life in a large proportion of RA patients, with achieving disease remission, or at least LDA being the goal of the treatment [ 5 ]. The possibility that better disease control, as encouraged by a T2T approach, presents an opportunity to not only improve clinical outcomes but also to potentially lower healthcare costs [ 6 ].…”