Date: 27 Feb 2013

I farmaci biologici nel trattamento dell’artrite reumatoide. Focus su etanercept

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Summary

This study assesses the cost-effectiveness of biological drugs for the treatment of rheumatoid arthritis (RA). RA, a chronic, autoimmune, inflammatory disease, affects about 0.5–1% of adult population worldwide. This disease also affects patients’ physical functioning, their psychological and social health and is associated with premature mortality. In addition, RA results in a substantial economic burden to patients, their families, healthcare systems and society. This economic burden is partially attributable to indirect costs, that have been considered to be substantially higher than direct costs. In the last few years, the availability of new classes of drugs for the treatment of RA has greatly improved clinical outcomes. The newest drugs developed for RA are biological agents (infliximab, adalimumab, and etanercept) that inhibit the pro-inflammatory cytokines responsible for autoimmune reaction in the disease (TNF-α). With reference to principal guidelines, advantages of this new class of drugs compared with traditional disease modifying anti-rheumatic drugs (DMARDs) include much more rapid onset of action and powerful effects on stopping progressive joint damage. Particularly, etanercept shows statistically important differences in effectiveness, and NICES’s pharmacoeconomic models underline its cost-effectiveness in comparison with adalimumab and infliximab, either as first line treatment or after failure of two therapies with DMARDs. Finally, etanercept doesn’t need increases in dosing during the therapy compared with other biological drugs so its annual cost for the National Health Service results to be stable.