Valutazione economica di etanercept nel trattamento dell’Artrite Reumatoide
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- Ravasio, R. & Lucioni, C. Pharmacoeconomics-Ital-Res-Articles (2006) 8: 129. doi:10.1007/BF03320563
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Economic evaluation of etanercept in AR
A review of literature concerning the cost-effectiveness analysis of etanercept, alone or in combination, versus DMARDs, NSAIDs, corticosteroids, and other biological agents in the treatment of Rheumatoid Arthritis.
The research of the literature was conducted using EMBASE and MEDLINE (2000–2006). Search terms were ‘cost-utility’, ‘cost-effectiveness’, ‘rheumatoid arthritis’, and ‘etanercept’. We considered only cost-effectiveness analyses. Six papers were selected, four based on cost-utility studies, and two on cost-effectiveness studies.
The cost-utility studies were conducted in four countries (UK, Spain, Sweden, and Japan) with similar methodologies. In the UK study the incremental cost per QALY gained of etanercept versus DMARDs was £16,333. The Spanish economic evaluation suggested that etanercept was a dominant strategy versus infliximab + methotrexate. In Sweden, an incremental cost per QALY gained of etanercept + methotrexate versus methotrexate of €37,331 was estimated. The Japanese study showed for etanercept an incremental cost per QALY gained of 2.5 million yen versus DMARDs. Two cost-effectiveness analyses were performed by the same group of researchers. They used the same methodologies; in the former study they considered methotrexate-naïve patients, in the latter metho-trexate-resistant patients. They calculated the incremental cost-effectiveness ratios as the additional cost per patient achieving ACR20 or ACR70 for etanercept alone or in combination with methotrexate, versus several competitors. Etaner-cept resulted cost-effective in every comparison.
This review suggests that etanercept, alone or in combination with methotrexate, is a cost-effective or dominant strategy compared with DMARDs, NSAIDs, corticosteroids, and other biological agents in the treatment of Rheumatoid Arthritis.