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Cost-effectiveness modeling of abatacept versus other biologic agents in DMARDS and anti-TNF inadequate responders for the management of moderate to severe rheumatoid arthritis

Russell, Anthony ; Beresniak, Ariel ; Bessette, Louis ; Haraoui, Boulos ; Rahman, Proton ; Thorne, Carter ; Maclean, Ross ; Dupont, Danielle

In: Clinical Rheumatology, 2009, vol. 28, no. 4, p. 403-412

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    Titre
    • Cost-effectiveness modeling of abatacept versus other biologic agents in DMARDS and anti-TNF inadequate responders for the management of moderate to severe rheumatoid arthritis
    Auteur
    • Russell, Anthony. University of Alberta, Edmonton, Canada
    • Beresniak, Ariel. LIRAES, Paris-Descartes University, Paris, France
    • Bessette, Louis. Centre Hospitalier Universitaire de Québec-CHUL, Québec, Canada
    • Haraoui, Boulos. University of Montreal, Montreal, Canada
    • Rahman, Proton. St. Clare's Mercy Hospital, St. John's, Newfoundland, Canada
    • Thorne, Carter. Southlake Regional Health Center, University of Toronto, Toronto, Canada
    • Maclean, Ross. Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA
    • Dupont, Danielle. Bristol-Myers Squibb International Corporation, Braine L'Alleud, Belgium
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317507
    Summary
    To assess the cost-effectiveness of abatacept compared to different biologic treatment strategies for moderate to severe rheumatoid arthritis based on current medical practices in Canada. A model was constructed to assess the cost-effectiveness of various biologic treatments over a 2-year time horizon, using two effectiveness endpoints: "low disease activity state” (LDAS) and "remission”. Abatacept, as first biologic agent after an inadequate response to DMARDs, provides greater treatment success rate for achieving LDAS (29.4% versus 15.6%) and remission (14.8% versus 5.2%), and appears significantly more cost-effective compared to the sequential use of anti-TNF agents (p < 0.001). Abatacept, as second biologic agent after an inadequate response to one anti-TNF agent, provides greater treatment success rate for achieving LDAS (17.1% versus 10.2%) and remission (7.4% versus 3.9%) and appears significantly more cost-effective compared to the sequential use of anti-TNF agents (p < 0.001). Abatacept is a cost-effective strategy in patients with an inadequate response to DMARDs or to one anti-TNF agent