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Cost-effective analysis of disease-modifying anti-rheumatic drugs in rheumatoid arthritis

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Abstract

The main objective of the study was to perform the pharmacoeconomic analysis of synthetic disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients. A prospective, observational study was conducted in 98 rheumatoid arthritis (RA) patients meeting 2010 Rheumatoid Arthritis Classification Criteria. Treatment-naive RA patients were initiated on synthetic disease-modifying anti-rheumatic drugs (DMARD/s) and followed up for 3 months. Average cost-effectiveness analysis was done by taking Health Assessment Questionnaire Disability Index (HAQ-DI) score as a measure of effectiveness. Out of the 98 RA patients, 15.30% were males and 84.69% females. 80.61% RA patients are seropositive. Majority of the study population patients (55%) were on combination of three synthetic DMARDs and almost a quarter (24.48%) were on combination of two synthetic DMARDs. The mean value of DAS 28 at baseline was 6.07 ± 1.33 and after 3 months treatment, the mean was 3.84 ± 1.11. The mean disability index measured by HAQ-DI was significantly reduced from 1.43 ± 0.71 to 0.81 ± 0.61, p < 0.001, after 3 months treatment. The direct medical cost of treatment of RA per month is 997.05 rupees. The average cost-effectiveness ratio of combination of synthetic DMARDs was 1533.92 rupees. Treatment of RA with synthetic DMARDs controls disease activity and improves disability with reasonable cost of treatment. The majority of the direct medical cost is attributable to cost of medicine and laboratory investigation. Use of quality generic drugs and an early diagnosis would minimize the economic burden on the patient.

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References

  1. Syngle A (2006) Arthritis and its treatment. In Rattan S, Kassem M, editiors Prevention and treatment of age-related diseases. The Netherlands. Spring 2006:105–132

    Google Scholar 

  2. Symmons D (2005) Looking back: rheumatoid arthritis-aetiology, occurrence and mortality. Rheumatology 44(suppl 4):iv14–iiv7

    PubMed  Google Scholar 

  3. Malaviya A, Kapoor S, Singh R, Kumar A, Pande I (1993) Prevalence of rheumatoid arthritis in the adult Indian population. Rheumatol Int 13(4):131–134

    Article  CAS  PubMed  Google Scholar 

  4. Singh JA, Saag KG, Bridges SL, Akl EA, Bannuru RR, Sullivan MC et al (2016) 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 68(1):1–26

    Article  PubMed  Google Scholar 

  5. Kavanaugh A (2007) Economic issues with new rheumatologic therapeutics. Curr Opin Rheumatol 19(3):272–276

    Article  PubMed  Google Scholar 

  6. Prashker MJ, Meenan RF (1995) The total costs of drug therapy for rheumatoid arthritis. Arthritis Rheumatol 38(3):318–325

    Article  CAS  Google Scholar 

  7. Kavanaugh A, Heudebert G, Cush J, Jain R (1996) Cost evaluation of novel therapeutics in rheumatoid arthritis (CENTRA): a decision analysis model. Semin Arthritis Rheum 25:297–307

    Article  CAS  PubMed  Google Scholar 

  8. Anis A, Tugwell P, Wells G, Stewart D (1996) A cost effectiveness analysis of cyclosporine in rheumatoid arthritis. J Rheumatol 23:609–613

    CAS  PubMed  Google Scholar 

  9. Akobundu E, Ju J, Blatt L, Mullins CD (2006) Cost-of-illness studies. PharmacoEconomics 24(9):869–890

    Article  PubMed  Google Scholar 

  10. Shini V, Aboobacker S, Pahuja S, Revikumar K, Bhasi R (2010) Pharmacoeconomic study of DMARDs in the management of rheumatoid arthritis. Int J Pharm Sci Rev Res 5(3):148–154

    Google Scholar 

  11. Gawde SR, Shetty YC, Merchant S, Kulkarni UJ, Nadkar MY (2013) Drug utilization pattern and cost analysis in rheumatoid arthritis patients—a cross-sectional study in tertiary care hospital, Mumbai. British Journal of Pharmaceutical Research 3(1):37–45

    Article  Google Scholar 

  12. Alex V, Cheruvallikattil S, Abraham S, Varghese B (2015) Cost of illness of rheumatoid arthritis in south India. World Journal of Pharmaceutical Research 4(11):1305–1315

    Google Scholar 

  13. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO et al (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581

    Article  PubMed  Google Scholar 

  14. Chopra A (2004) Rheumatology: made in India (Camps, COPCORD, HLA, Ayurveda, HAQ, WOMAC and drug trials). J Indian Rheum Assoc 12:43–53

    Google Scholar 

  15. Revikumar KG, Miglani BD (2009) A text book of pharmacy practice, 1st Ed, Vol 1, Career Publications, India, 2009, 447–56

  16. Prajapati S, Sahu VK, Tripathy S (2011) ECHO model for rheumatoid arthritis. The Pharm Res 5(1):1–11

    Article  Google Scholar 

  17. Goronzy J, Cornelia M (1997) Rheumatoid arthritis epidemiology, pathology and pathogenesis. In: Klippel JH, Wehand CM, Wortmann RL (eds) Primer on the rheumatic disease, 11th edn. William M, Georgia

    Google Scholar 

  18. Schellekens GA, Visser H, De Jong BA, Van Den Hoogen FH, Hazes JM, Breedveld FC et al (2000) The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 43(1):155–163

    Article  CAS  PubMed  Google Scholar 

  19. Lau CS, Chia F, Harrison A, Hsieh TY, Jain R, Jung SM et al (2015) APLAR rheumatoid arthritis treatment recommendations. Int J Rheum Dis 18(7):685–713

    Article  PubMed  Google Scholar 

  20. Smolen JS, Aletaha D, Bijlsma JW, Breedveld FC, Boumpas D, Burmester G et al (2010) Treat-to-target: rationale and strategies. Ann Rheum Dis 69:631–637

    Article  PubMed  PubMed Central  Google Scholar 

  21. Sukhpreet AV, Tiwari P (2007) Treatment and monitoring costs in rheumatoid arthritis: preliminary results from an Indian setting. Indian J Pharm Sci 69(2):226–231

    Article  Google Scholar 

  22. Zhu TY, Tam LS, Li EK (2011) Societal costs of rheumatoid arthritis in Hong Kong: a prevalence-based cost-of-illness study. Rheumatology (Oxford) 50(7):1293–1301

    Article  Google Scholar 

  23. Tanaka E, Inoue E, Mannalithara A, Bennett M, Kamitsuji S, Taniguchi A et al (2010) Medical care costs of patients with rheumatoid arthritis during the prebiologics period in Japan: a large prospective observational cohort study. Mod Rheumatol 20(1):46–53

    Article  PubMed  Google Scholar 

  24. Osiri M, Maetzel A, Tugwell P (2007) The economic burden of rheumatoid arthritis in a developing nation: results from a one-year prospective cohort study in Thailand. J Rheumatol 34(1):57–63

    PubMed  Google Scholar 

  25. Franke LC, Ament AJ, van de Laar MA, Boonen A, Severens JL (2009) Cost-of-illness of rheumatoid arthritis and ankylosing spondylitis. Clin Exp Rheumatol 27:S118–S123

    CAS  PubMed  Google Scholar 

  26. Yelin E, Wanke LA (1999) An assessment of the annual and long-term direct costs of rheumatoid arthritis: the impact of poor function and functional decline. Arthritis Rheum 42(6):1209–1218

    Article  CAS  PubMed  Google Scholar 

  27. Michaud K, Messer J, Choi HK, Wolfe F (2003) Direct medical costs and their predictors in patients with rheumatoid arthritis: a three-year study of 7,527. Arthritis Rheum 48(10):2750–2762

    Article  PubMed  Google Scholar 

  28. Verhoeven AC, Bibo JC, Boers M, Engel GL, van der Linden S (1998) Cost-effectiveness and cost-utility of combination therapy in early rheumatoid arthritis: randomized comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone. COBRA Trial Group. Combinatie therapie Bij Reumatoide Artritis. Br J Rheumatol 37(10):1102–1109

    Article  CAS  PubMed  Google Scholar 

  29. Choi HK, Seeger JD, Kuntz KM (2000) Cost-effectiveness analysis of treatment options for patients with methotrexate-resistant rheumatoid arthritis. Arthritis Rheum 8:304–310

    Google Scholar 

  30. Kawatkar AA, Jacobsen SJ, Levy GD et al (2012) Direct medical expenditure with rheumatoid arthritis in a nationally representative sample from the medical expenditure panel survey. Arthritis Care Res 64(11):1649–1656

    Article  Google Scholar 

  31. Cooper NJ (2000) Economic burden of rheumatoid arthritis: a systemic review. Rheumatology 39:28–33

    Article  CAS  PubMed  Google Scholar 

  32. Lapsley HM, March JM, Tribe KL, Cross MJ, Courtenay BG, Brooks PM (2002) Living with rheumatoid arthritis: expenditures, health status, and social impact on patients. Ann Rheum Dis 61:818–821

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Cardio-Rheuma & Healing Touch City Clinic, Chandigarh, India

    Ashit Syngle, Sudeep Kaur & Vijaita Syngle

  2. FortisMulti Specialty Hospital, Mohali, India

    Ashit Syngle

  3. Maharishi Markandeshwar College of Pharmacy, Ambala, India

    Inderjeet Verma

  4. Healing Touch Foundation, Chandigarh, India

    Tanya Syngle

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  1. Ashit Syngle
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  2. Sudeep Kaur
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  3. Inderjeet Verma
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  4. Tanya Syngle
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  5. Vijaita Syngle
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Correspondence to Ashit Syngle.

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The study protocol was approved by the Institutional Clinical Ethics Committee (ICEC) and conducted according to the Declaration of Helsinki.

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Syngle, A., Kaur, S., Verma, I. et al. Cost-effective analysis of disease-modifying anti-rheumatic drugs in rheumatoid arthritis. Clin Rheumatol 36, 1715–1720 (2017). https://doi.org/10.1007/s10067-017-3725-3

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  • DOI: https://doi.org/10.1007/s10067-017-3725-3

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