Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Infliximab (Remicade®), a biological disease-modifying antirheumatic drug (DMARD), binds to and inhibits the activity of tumour necrosis factor-α, which is thought to play an important role in the pathophysiology of rheumatoid arthritis. Intravenous infliximab plus methotrexate is recommended in patients with rheumatoid arthritis who have not achieved satisfactory disease control with adequate courses of other DMARDs.
Pharmacoeconomic analyses have been based on efficacy data from the pivotal placebo-controlled Anti-Tumour Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy (ATTRACT) trial in patients with active, refractory rheumatoid arthritis. Infliximab every 8 weeks plus methotrexate demonstrated rapid and sustainable improvements in clinical response, delayed radiographic progression, and/or improved functional status and health-related QOL compared with placebo plus methotrexate at weeks 30, 54 and 102.
In cost-utility analyses of infliximab plus methotrexate conducted from a healthcare payer and/or societal perspective in the US, Europe, Portugal, Sweden and the UK, infliximab 3 mg/kg every 8 weeks plus methotrexate was associated with acceptable (<$US50 000 per discounted QALY gained) cost-utility ratios relative to methotrexate alone in patients with active, refractory rheumatoid arthritis. When only direct costs were considered, the lifetime incremental cost per discounted QALY gained with infliximab plus methotrexate relative to methotrexate alone was $US30 500–38 700 (year of costing 1998 or not reported; treatment duration 54 or 102 weeks or lifelong) in the US and Europe analyses, and €39 500 (year of costing not reported; lifelong treatment) in the Portuguese analysis. The cost-utility ratios were more favourable when lost productivity costs or the additional benefit of infliximab on radiographic stabilisation were considered. In the Swedish and UK analyses with a 10-year time horizon, infliximab plus methotrexate for 1 or 2 years was associated with cost-utility ratios of €28 600–56 100 (year of costing not reported) when direct costs were considered, and €3440–48 200 when direct costs plus loss-of-productivity costs were considered.
In conclusion, cost-utility analyses, which were based on modelling of data from the pivotal clinical trial of infliximab plus methotrexate, indicate that infliximab plus methotrexate is associated with acceptable cost-effectiveness ratios (<$US50 000 per discounted QALY gained) relative to methotrexate monotherapy in patients with active rheumatoid arthritis who have not responded to previous methotrexate or other DMARD therapy. The cost effectiveness of infliximab versus other DMARDs is at present unclear, but will be clarified when appropriate data from directly comparative clinical and/or pharmacoeconomic studies become available. In patients in whom adequate courses of other DMARDs have failed to achieve satisfactory disease control, infliximab plus methotrexate may prevent or delay disability, which may produce reductions in nondrug costs that can help offset its acquisition cost.
Rheumatoid arthritis is a chronic autoimmune disease characterised by symmetrical joint swelling and tenderness, stiffness in the morning that lasts for an hour or longer, subcutaneous rheumatoid nodules, and radiographic evidence of joint damage. An inflammatory cascade, which involves the secretion of inflammatory mediators including tumour necrosis factor-á and results in the destruction and resorption of articular cartilage and bone, appears to play a role in its pathogenesis. Rheumatoid arthritis has a worldwide prevalence of approximately 1%, is generally progressive and is associated with pain, loss of function, disability and an increased risk of premature mortality.
Rheumatoid arthritis is associated with substantial direct, indirect and intangible costs, which increase as the severity of the disease increases. Healthcare costs are approximately 2- to 3-fold higher in patients with rheumatoid arthritis than in age-matched individuals without rheumatoid arthritis. Drug costs are the largest contributors to direct healthcare costs; disability-related loss of productivity is the largest contributor to indirect costs. Rheumatoid arthritis can impair the individual’s health-related QOL (HR-QOL), psychological well being and physical function, which results in considerable intangible costs.
Recent guidelines recommend early aggressive treatment of rheumatoid arthritis, as early treatment may prevent or delay disease progression. The majority of patients with rheumatoid arthritis should be started on disease-modifying antirheumatic drug (DMARD) therapy within 3 months of diagnosis. Biological DMARDs, such as infliximab, are recommended in the treatment of patients in whom adequate courses of other DMARDs have failed to achieve satisfactory disease control or have resulted in adverse effects limiting their use.
In randomised, placebo-controlled, double-blind, multicentre trials, noncomparative trials and in clinical practice, multiple infusions of infliximab in combination with methotrexate resulted in rapid, sustainable clinical responses in patients with active, refractory rheumatoid arthritis who had not responded to previous DMARD therapy.
In the pivotal Anti-Tumour Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy (ATTRACT) trial, response to intravenous infliximab 3 or 10 mg/kg at weeks 0, 2 and 6 plus methotrexate (median dosage 15 mg/week) was rapid (within 2 weeks of starting treatment) and was maintained for up to 102 weeks with continued infliximab treatment every 4 or 8 weeks. American College of Rheumatology (ACR) 20, 50 and 70 response rates were significantly higher with infliximab plus methotrexate than with methotrexate plus placebo after 30 and 54 weeks’ treatment. At 102 weeks, a significantly greater proportion of infliximab plus methotrexate recipients than methotrexate plus placebo recipients had an ACR20 response (42.6% vs 15.9%). Radiographic progression was significantly less in the combined infliximab plus methotrexate group than in the methotrexate plus placebo group at weeks 54 and 102 (mean change in total radiographic score 0.6 vs 7 points and 0.7 points vs 12.6 points).
Functional disability and HR-QOL also improved with infliximab plus methotrexate. In the ATTRACT trial, median improvements from baseline in Health Assessment Questionnaire (HAQ) scores and physical component summary scores of the Medical Outcomes Study Short-form 36-item Health Survey were significantly greater in the combined infliximab plus methotrexate group than in the methotrexate plus placebo group at week 54 (23% vs 3% and 34% vs 9%).
Infliximab plus methotrexate may improve the ability for individuals with rheumatoid arthritis to participate in the work force.
In retrospective clinical practice studies in the US, patients with rheumatoid arthritis receiving infliximab tend to stay longer on therapy, have a lower rate of discontinuation and higher rates of compliance than those receiving methotrexate and/or etanercept.
In clinical trials involving patients with rheumatoid arthritis, adverse events associated with infliximab were generally mild in severity. Patients receiving infliximab plus methotrexate and those receiving methotrexate plus placebo had similar incidences of total (95% vs 94%) and serious adverse events (44% vs 35%) in the ATTRACT trial. Infusion-related reactions were more common with infliximab than placebo, and were generally mild to moderate in severity. Infections were the most common serious adverse events.
The cost utility of infliximab plus methotrexate relative to methotrexate in Analyses patients with active refractory rheumatoid arthritis was predicted by incorporating efficacy data from the ATTRACT trial into HAQ-based Markov models. These analyses assumed that therapies with a cost per QALY gained of <$US50 000 or <€50 000 are cost effective. Using a Markov model and considering only direct healthcare costs, infliximab 3 mg/kg administered every 8 weeks plus methotrexate was cost effective relative to methotrexate in analyses with a lifetime horizon in the US and Europe (cost per discounted QALY gained $US30 500–38 700; year of costing 1998 or not reported; treatment duration 54 or 102 weeks or lifelong) and Portugal (€39 500; year of costing not reported; lifelong treatment). The discounted incremental cost per QALY gained is further improved when societal (loss of productivity) costs are considered in addition to direct costs, or when the additional benefit of infliximab on radiographic stabilisation is considered. In Swedish and UK analyses with a 10-year time horizon that used a different Markov model, treatment with infliximab 3 mg/kg every 8 weeks plus methotrexate administered over 1 or 2 years was associated with incremental discounted costs per QALY gained relative to methotrexate monotherapy of €28 600–56 100 (year of costing not reported) when direct costs were considered and €3440–48 200 when direct costs plus loss-of-productivity costs were considered. Infliximab plus methotrexate remained cost effective with the input of reasonable variations in key model parameters in sensitivity analyses. Using an alternative model (which eliminated the placebo effect in the methotrexate treatment group with or without a loss of effect in the year after discontinuation) in sensitivity analysis, infliximab plus methotrexate for 1 year was cost saving relative to methotrexate alone when direct plus indirect costs were considered in the Swedish study.
In 1-year cost analyses conducted from a societal or healthcare perspective in The Netherlands and the US, the per-patient total annual costs of infliximab were greater than those of etanercept. Although the annual per-patient drug costs of the agents were similar, other annual medical costs were higher with infliximab than with etanercept and were driven by assumptions made regarding costs associated with administering intravenous infliximab in an outpatient facility. The cost of administration can vary substantially across regions and settings. In a French analysis, the relative 1-year costs of infliximab and etanercept were influenced by the setting in which etanercept was dispensed.
- Centocor Inc. Remicade (infliximab recombinant) for IV injection: US prescribing information [online]. Available from URL: http://www.remicade.com [Accessed 2003 May 20]
- Feldmann M, Maim RN. Anti-TNF alpha therapy of rheumatoid arthritis: what have we learned? Annu Rev Immuno12001; 19: 163–96 CrossRef
- Brennan FM, Maim RN, Feldmann M. TNFalpha - a pivotal role in rheumatoid arthritis? Br J Rheumatol 1992; 31 (5): 293–8 CrossRef
- Summary of product characteristics for infliximab (Remicade) [online]. Available from URL: http://www.emea.eu.int [Accessed 2003 Aug 25]
- Keating GM, Perry CM. Infliximab: an updated review of its use in Crohn’s disease and rheumatoid arthritis. BioDrugs 2002; 16 (2): 111–48 CrossRef
- American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum 2002; 46 (2): 328–46 CrossRef
- Drossaers-Bakker KW, de Buck M, Van Zeben D, et al. Longterm course and outcome of functional capacity in rheumatoid arthritis: the effect of disease activity and radiologic damage over time. Arthritis Rheum 1999 Sep; 42 (9): 1854–60 CrossRef
- Welsing PM, van Gestel AM, Swinkels HL, et al. The relationship between disease activity, joint destruction and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum 2001 Sep; 44 (9): 2009–17 CrossRef
- Smith JB, Haynes MK. Rheumatoid arthritis - a molecular understanding. Ann Intern Med 2002 Jun 18; 136 (12): 908–22
- Fox DA. Cytokine blockade as a new strategy to treat rheumatoid arthritis: inhibition of tumor necrosis factor. Arch Intern Med 2000 Feb 28; 160 (4): 437–44 CrossRef
- Van der Heijde DM, van Riel PL, van Leeuwen MA, et al. Prognostic factors for radiographic damage and physical disability in early rheumatoid arthritis: a prospective follow-up study of 147 patients. Br J Rheumatol 1992 Aug; 31 (8): 519–25 CrossRef
- Paleolog E. The therapeutic potential of TNF-alpha blockade in rheumatoid arthritis. Expert Opin Investig Drugs 2003 Jul; 12 (7): 1087–95
- Hulsmans HM, Jacobs JW, Van der Heijde DM, et al. The course of radiologic damage during the first six years of rheumatoid arthritis. Arthritis Rheum 2000 Sep; 43 (9): 1927–40 CrossRef
- van der Heijde DMFM. Plain X-rays in rheumatoid arthritis: overview of scoring methods, their reliability and applicability. Baillieres Clin Rheumatology 1996 Aug; 10: 435–53 CrossRef
- Pincus T. The underestimated long term medical and economic consequences of rheumatoid arthritis. Drugs 1995; 50 Suppl. 1: 1–14 CrossRef
- National Institute for Clinical Excellence. Guidance on the use of etanercept and infliximab for the treatment of rheumatoid arthritis. London: National Institute for Clinical Excellence, 2002 Mar; Technology appraisal guidance no. 36
- Gabriel SE, Crowson CS, Kremers HM, et al. Survival in rheumatoid arthritis: a population-based analysis of trends over 40 years. Arthritis Rheum 2003 Jan; 48 (1): 54–8 CrossRef
- Bjomadal L, Baecklund E, Yin L, et al. Decreasing mortality in patients with rheumatoid arthritis: results from a large population based cohort in Sweden, 1964–95. J Rheumatol 2002; 29 (5): 906–12
- Mikuls TR, Saag KG. Comorbidity in rheumatoid arthritis. Rheum Dis Clin North Am 2001 May; 27 (2): 283–303
- Wolfe F, Michaud K, Gefeller O, et al. Predicting mortality in patients with rheumatoid arthritis. Arthritis Rheum 2003 Jun; 48 (6): 1530–42 CrossRef
- Peltomaa R, Paimela L, Kautiainen H, et al. Mortality in patients with rheumatoid arthritis treated actively from the time of diagnosis. Ann Rheum Dis 2002 Oct; 61 (10): 889–94 CrossRef
- Krause D, Schleusser B, Herborn G, et al. Response to methotrexate treatment is associated with reduced mortality in patients with severe rheumatoid arthritis. Arthritis Rheum 2000 Jan; 43 (1): 14–21 CrossRef
- Choi HK, Heman MA, Seeger JD, et al. Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 2002 Apr 6; 359 (9313): 1173–7 CrossRef
- Pincus T, Callahan LF, Fuchs HA, et al. Quantitative analysis of hand radiographs in rheumatoid arthritis: time course of radiographic changes, relation to joint examination measures, and comparison of different scoring methods. J Rheumatol 1995 Oct; 22 (10): 1983–9
- Clarke AE, St. Pierre Y, Joseph L, et al. Radiographic damage in rheumatoid arthritis correlates with functional disability but not direct medical costs. J Rheumatol 2001 Nov; 28 (11): 2416–24
- Emery P, Reginster JY, Appelboom T, et al. WHO Collaborating Centre consensus meeting on anti-cytokine therapy in rheumatoid arthritis. Rheumatology (Oxford) 2001 Jun; 40 (6): 699–702 CrossRef
- Rooney BK, Silman AJ. Epidemiology of rheumatic diseases. Curr Opin Rheumatol 1999; 11 (2): 91–7 CrossRef
- Symmons DP. Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol 2002 Dee; 16 (5): 707–22
- Toussirot E, Auge B, Tiberghien P, et al. HLA-DRB1 alleles and shared amino acid sequences in disease susceptibility and severity in patents from eastern France with rheumatoid arthritis. J Rheumatol 1999 Jul; 26 (7): 1446–51
- Karlson EW, Lee IM, Cook NR, et al. A retrospective cohort study of cigarette smoking and risk of rheumatoid arthritis in female health professionals. Arthritis Rheum 1999 May; 42 (5): 910–7 CrossRef
- Cooper NJ. Economic burden of rheumatoid arthritis: a systematic review. Rheumatology (Oxford) 2000 Jan; 39 (1): 28–33 CrossRef
- Lapsley HM, March LM, Tribe KL. Living with rheumatoid arthritis: expenditures, health status, and social impact on patients. Ann Rheum Dis 2002 Sep; 61 (9): 818–21 CrossRef
- Leardini G, Salaffi F, Montanelli R, et al. A multicenter cost-ofillness study on rheumatoid arthritis in Italy. Clin Exp Rheumatol 2002 Jul-Aug; 20 (4): 505–15
- Van Jaarsveld CHM, Jacobs JWG, Schrijvers AJP, et al. Direct cost of rheumatoid arthritis during the first six years: a cost-ofillness study. Br J Rheumatol 1998 Aug; 37 (8): 837–47 CrossRef
- Pugner KM, Scott DI, Holmes JW, et al. The costs of rheumatoid arthritis: an international long-term view. Semin Arthritis Rheum 2000 Apr; 29 (5): 305–20 CrossRef
- Lubeck DP. A review of the direct costs of rheumatoid arthritis: managed care versus fee-for-service settings. Pharmacoeconomics 2001; 19 (8): 811–8 CrossRef
- Gabriel SE, Crowson CS, Campion ME, et al. Indirect and nonmedical costs among people with rheumatoid arthritis and osteoarthritis compared with nonarthritic controls. J Rheumatol 1997 Jan; 24 (1): 43–8
- Birnbaum HG, Barton M, Greenberg PE, et al. Direct and indirect costs of rheumatoid arthritis to an employer. J Occup Environ Med 2000 Jun; 42 (6): 588–96 CrossRef
- Michaud K, Messer J, Choi HK, et al. Direct medical costs and their predictors in patients with rheumatoid arthritis: a threeyear study of 7,527 patients. Arthritis Rheum 2003 Oct; 48 (10): 2750–62 CrossRef
- Fex E, Larsson BM, Nived K, et al. Effect of rheumatoid arthritis on work status and social and leisure time activities in patients followed 8 years from onset. J Rheumatol 1998 Jan; 25 (1): 44–50
- Young A, Dixey J, Kulinskaya E, et al. Which patients stop working because of rheumatoid arthritis? Results of five years’ follow up in 732 patients from the Early RA Study (ERAS). Ann Rheum Dis 2002 Apr; 61 (4): 335–40 CrossRef
- Barrett EM, Scott DGI, Wiles NJ, et al. The impact of rheumatoid arthritis on employment status in the early years of disease: a UK community-based study. Rheumatology (Oxford) 2000; 39 (2): 1403–9 CrossRef
- Yelin E, Wanke LA. An assessment of the annual and long-term direct costs of rheumatoid arthritis. Arthritis Rheum 1999 Jun; 42 (6: 1209–18
- Ethgen O, Kahler KH, Kong SX, et al. The effect of health related quality of life on reported use of health care resources in patients with osteoarthritis and rheumatoid arthritis: a longitudinal analysis. J Rheumatol 2002 Jun; 29 (6: 1147–55
- Hawley DJ, Wolfe F. Anxiety and depression in patients with rheumatoid arthritis: a prospective study of 400 patients. J Rheumatol 1988 Jun; 15 (6: 932–41
- Katz PP, Yelin EH. Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis. J Rheumatol 1993; 20 (5): 790–6
- Drosos AA. Methotrexate intolerance in elderly patients with rheumatoid arthritis: what are the alternatives? Drugs Aging 2003; 20 (10): 723–36 CrossRef
- Maim R, St Clair EW, Breedveld F, et al. Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group. Lancet 1999 Dec 4; 354 (9194): 1932–9 CrossRef
- Lipsky PE, van der Heijde DM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. AntiTumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000 Nov 30; 343 (22): 1594–602 CrossRef
- Maim RN, Breedveld FC, Kalden JR, et al. Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor a monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 1998 Sep; 41 (9): 1552–63 CrossRef
- Kavanaugh A, St Clair EW, McCune WJ, et al. Chimeric antitumor necrosis factor-alpha monoclonal antibody treatment of patients with rheumatoid arthritis receiving methotrexate therapy. J Rheumatol 2000 Apr; 27 (4): 841–50
- Fantini F, Sinigaglia L, Zeni S, et al. Short-term treatment with monoclonal anti-tumor necrosis factor-alpha antibody in refractory long-standing rheumatoid arthritis [abstract no. 964]. Arthritis Rheum 2000 Sep; 43 (9 Suppl.): 227
- Antoni CE, Dechant C, Haentzschel H, et al. Safety and efficacy of infliximab in 263 patients with active rheumatoid arthritis (RA) despite mehtotrexate therapy: a German open label trial [abstract no. 187]. Arthritis Rheum 2001 Sep; 44 (9 Suppl.): S84
- Shergy WJ, Isern RA, Cooley DA, et al. Open label study to assess infliximab safety and timing of onset of clinical benefit among patients with rheumatoid arthritis. J Rheumatol 2002 Apr; 29 (4): 667–77
- Fitzcharles MA, Clayton D, Menard HA. The use of infliximab in academic rheumatology practice: an audit of early clinical experience. J Rheumatol 2002 Dec; 29 (12): 2525–30
- Lipsky P, van der Heijde D, St Clair W, et al. 102-Week clinical and radiologic results from the ATTRACT trial: a 2 year, randomized, controlled, phase 3 trial of infliximab (Remicade) in pis with active RA despite MTX [abstract no. 1216]. Arthritis Rheum 2000 Sep; 43 (9 Suppl.): S269
- Kavanaugh A, Lipsky P, Furst D, et al. Infliximab improves long-term quality of life and functional status in patients with rheumatoid arthritis [abstract no. 483]. Arthritis Rheum 2000 Sep; 43 (9 Suppl.): S147
- Kavanaugh A, Han C, Bala M, et al. Successful treatment improves employability in patients with rheumatoid arthritis [abstract no. SAT0327]. Annual European Congress of Rheumatology; 2002 Jun 12–15; Stockholm
- Wong JB, Lipsky PE, Maim R, et al. Rapid radiographic progression in rheumatoid arthritis and clinical and radiographic benefits from infliximab: results from ATTRACT [abstract no. 854]. Arthritis Rheum 2002 Sep; 46 (9 Suppl.): S337
- Kiely PDW, Johnson DM. Infliximab and leflunomide combination therapy in rheumatoid arthritis: an open-label study. Rheumatology (Oxford) 2002 Jun; 41 (6: 631–7
- Temekonidis TI, Georgiadis AN, Alamanos Y, et al. Infliximab treatment in combination with cyclosporin A in patients with severe refractory rheumatoid arthritis. Ann Rheum Dis 2002 Sep; 61 (9): 822–5 CrossRef
- Felson DT, Anderson JJ, Boers M, et al. American College of Rheumatology preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum 1995; 38 (6: 727–35
- Fries IF, Spitz P, Kraines RG, et al. Measurement of patient outcome in arthritis. Arthritis Rheum 1980 Feb; 23 (2): 137–45 CrossRef
- Ware JE, Sherboume CD. The MOS 36-item short-form health survey (SF-36. I. Conceptual framework and item selection. Med Care 1992 Jun; 30 (6: 473–83
- van Vollenhoven RE Brannemark S, Lindblad S. Treatment with TNFalpha antagonists results in significant gradual increases in work-force participation: data from the STURE registry [abstract no. 1431]. Arthritis Rheum 2002 Sep; 46 (9 Suppl.): S535
- Harley CR, Frytak JR, Tandon N. Treatment compliance and dosage administration among rheumatoid arthritis patients receiving infliximab, etanercept, or methotrexate. Am J Manag Care 2003 Oct; 9 (6 Suppl.): S136–43
- Power DJ, Villanueva I, Yocum DE, et al. Comparison of survival curves between infliximab and etanercept: medication discontinuation as event [abstract no. 371]. Arthritis Rheum 2002 Sep; 46 (9 Suppl.): S171
- Singh G, Mithal A, Kavanaugh A. Treatment adherence with TNF-inhibitors and methotrexate in patients with rheumatoid arthritis is a large state Medicaid program [abstract no. PART]. Value Health 2003 Nov-Dec; 6 (6): 724. Plus poster presented at the International Society for Pharmacoeconomics and Outcomes Research 6th Annual European Congress; 2003 Nov 9–11; Barcelona
- Flendrie M, Creemers MCW, Welsing PMJ, et al. Survival during treatment with tumour necrosis factor blocking agents in rheumatoid arthritis. Ann Rheum Dis 2003 Nov; 62 Suppl. II: ii30–3
- FDA Arthritis Advisory Committee Briefing Document. Information for the Arthritis Advisory Committee: Remicade (infliximab) efficacy and safety review [online]. Available from URL: http://www.fda.gov/ohrms/dockets/ac/03/briefing/ 3930B1 04 A-Centocor-Remicade%20.pdf [Accessed 2003 Aug 25]
- Chung ES, Packer M, Lo KH, et al. Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF Therapy Against Congestive Heart Failure (ATTACH) trial. Circulation 2003 Jul 1; 107 (25): 3133–40 CrossRef
- Wong JB, Singh G, Kavanaugh A. Estimating the cost-effectiveness of 54 weeks of infliximab for rheumatoid arthritis. Am J Med 2002 Oct 1; 113 (5): 400–8 CrossRef
- Wong JB, Breedveld FC, Smolen IS, et al. Cost-effectiveness of 102-weeks of infliximab for rheumatoid arthritis [abstract no. 1551]. Arthritis Rheum 2001 Sep; 44 (9 Suppl.): S311
- Wong JB, Breedveld FC, Smolen IS, et al. Estimating the costeffectiveness of lifelong infliximab for rheumatoid arthritis [abstract no. SAT0300]. Annual European Congress of Rheumatology; 2002 Jun 12–15; Stockholm
- Wong JB, Branco JC, Cobrado N. Cost-effectiveness of lifelong infliximab for rheumatoid arthritis in Portugal [abstract no. SAT0260]. Ann Rheum Dis 2003 Jul; 62 Suppl. 1: 360
- Kobelt G, Musson L, Young A, et al. The cost-effectiveness of infliximab (Remicade) in the treatment of rheumatoid arthritis in Sweden and the United Kingdom based on the ATTRACT study. Rheumatology (Oxford) 2003 Feb; 42 (2): 326–35 CrossRef
- Nuijten MJC, Engelfriet P, Duijn K, et al. A cost-cost study comparing etanercept with infliximab in rheumatoid arthritis. Pharmacoeconomics 2001; 19 (10): 1051–64 CrossRef
- Ollendorf DA, Peterson AN, Doyle J, et al. Impact of leflunomide versus biologic agents on the costs of care for rheumatoid arthritis in a managed care population. Am J Manag Care 2002 May; 8 (7 Suppl.): S203–13
- Fautrel B, Sibilia J, Woronoff M, et al. The substantial impact of the organisation of care on the costs of TNF alpha blocking agents: compared costs of infliximab and etanercept in the treatment of RA in France [abstract no. AB0646]. Ann Rheum Dis 2003 Jul; 62 Suppl. 1: 538–9
- Malone DC. Cost-effectiveness analysis of etanercept monotherapy versus infliximab plus methotrexate in the treatment of rheumatoid arthritis [abstract no. 1617]. Arthritis Rheum 2001 Sep; 44 (9 Suppl.): S322
- Malone DC, Ortmeier BG. Cost effectiveness analysis of etanercept versus infliximab in the treatment of rheumatoid arthritis patients [abstract no. SAT0236]. Ann Rheum Dis 2003 Jul; 62 Suppl. 1: 353
- Malone DC, Ortmeier BG. Cost efficacy of etanercept versus infliximab plus methotrexate in the treatment of DMARDresistant rheumatoid arthritis [abstract no. SAT0320]. Annual European Congress of Rheumatology; 2002 Jun 12–15; Stockholm
- Malone DC, Ortmeier BG. Cost efficacy of etanercept versus infliximab plus methotrexate in rheumatoid arthritis based on radiographic data [abstract no. SAT0312]. Annual European Congress of Rheumatology; 2002 Jun 12–15; Stockholm
- Leardini G, Ganguly R, Singh A. Cost-effectiveness analysis of etanercept versus infliximab and anakinra in the treatment of rheumatoid arthritis in Italy [abstract no. 1152]. Arthritis Rheum 2003 Sep; 48 (9 Suppl.): 460–1
- Chiou CF, Wanke LA, Reyes C, et al. Comparison of the costefficacy of biologics in the treatment of rheumatoid arthritis [abstract no. 598]. Arthritis Rheum 2003 Sep; 48 (9 Suppl.): S263
- Chiou CF, Wanke LA, Reyes C, et al. Biologics in rheumatoid arthritis: cost-efficacy based on clinically meaningful improvement in health assessment questionnaire scores [abstract no. 597]. Arthritis Rheum 2003 Sep; 48 (9 Suppl.): S263
- Bansback NJ, Brennan A, Sengupta N, et al. Cost effectiveness of adalimumab (Humira, Abbott) in the treatment of patients with moderate to severe rheumatoid arthritis (RA) [abstract no. 470]. Arthritis Rheum 2003 Sep; 48 (9 Suppl.): 215
- Bathon JM, Martin RW, Fleischmann RM, et al. A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis [published erratum appears in N Engl J Med 2001 Jan 18; 344 (3): 240]. N Engl J Med 2000 Nov 30; 343 (22): 1586–93
- Moreland LW, Schiff MIL Baumgartner SW, et al. Etanercept therapy in rheumatoid arthritis: a randomized, controlled trial. Ann Intern Med 1999 Mar 16; 130 (6: 478–86
- Wong JB, Ramey DR, Singh G. Long-term morbidity, mortality, and economics of rheumatoid arthritis. Arthritis Rheum 2001 Dee; 44 (12): 2746–9
- Kobelt G, Jonsson L, Lindgren P, et al. Modeling the progression of rheumatoid arthritis: a two-country model to estimate costs and consequences of rheumatoid arthritis. Arthritis Rheum 2002 Sep; 46 (9): 2310–9 CrossRef
- CEA Registry. League table of cost-utility analyses meeting panel criteria, with ratios converted to 1998 U.S. dollars [online]. Available from URL: http://www.hsph.harvard.edu/cearegistry/panel)_worthy.pdf [Accessed 2003 Aug 1]
- Hochberg MC, Tracy JK, Hawkins-Holt M, et al. Comparison of the efficacy of the tumour necrosis factor alpha blocking agents adalimumab, etanercept, and infliximab when added to methotrexate in patients with active rheumatoid arthritis. Ann Rheum Dis 2003 Nov; 62 Suppl. 2: ii 13–6
- Murray L. 2003 Drug Topics Red Book. Montvale (NJ): Thomson PDR, 2003
- Data on file. Centocor Inc., 2003
- Kremer JM. Rational use of new and existing disease-modifying agents in rheumatoid arthritis. Ann Intern Med 2001 Apr 17; 134 (8): 695–706
- Young A, Williams P, Dixey J, et al. How many patients with early rheumatoid arthritis are likely to need TNF-a blocking drugs? Results from a prospective study of 926 patients over 5 years [abstract no. 965]. Arthritis Rheum 2000 Sep; 43 (9 Suppl.): 227
- Yee C-S, Filer A, Pace A, et al. The prevalence of patients with rheumatoid arthritis in the West Midlands fulfilling the BSR criteria for anti-tumour necrosis factor therapy: an out-patient study. Rheumatology (Oxford) 2003 Jul; 42 (7): 856–9 CrossRef
Volume 22, Issue 2 , pp 107-132
- Cover Date
- Print ISSN
- Online ISSN
- Springer International Publishing
- Additional Links
- Industry Sectors