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Cost of Biologics in the Treatment of Juvenile Idiopathic Arthritis: A Factor not to be Overlooked

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Abstract

Biologics are a promising treatment option for juvenile idiopathic arthritis (JIA) but drug costs are very high compared to conventional treatment. From a socioeconomic view the additional costs of new interventions should be weighed against their incremental health benefits compared to standard care. Therefore we evaluated data on cost-effectiveness of biologics in JIA. We searched Medline, Embase, and The York Centre for Reviews and Dissemination database for relevant literature. Current data show that biologics are reducing direct and indirect healthcare costs if one excludes the costs of the drug itself. The costs of biologics are more than ten times as high as conventional drug treatment. As a result of limited data, no comparison on cost-effectiveness between biologics could be performed. Although data on long-term cost-effectiveness of biologics are lacking, the expectation is that they will be cost-effective in the long-term. The idea behind this is that biologic treatment should be administered to patients that without these drugs would incur high direct and indirect costs due to continuous severe disease resulting in irreversible disabilities. In our opinion the best cost benefit could be gained if these patients receive biologic treatment introduced early in the disease. This is in order to minimize irreversible damage to the joints and minimize need for long-term biologic therapy by early suppression of the disease. To support these hypotheses future research is needed on long-term cost-effectiveness of all biologics used in JIA.

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Acknowledgments

Dr. Prince has no conflicts of interest to declare. Dr. van Suijlekom-Smit received grants from the Dutch Board of Health Insurances, Dutch Arthritis Association, Pfizer (formerly Wyeth), and Abbott, received consulting fees, review activities fees, payment for lectures and travel expenses to meetings from Pfizer (formerly Wyeth), and received consultancy fees from Roche and Novartis, and travel expenses to meetings from Bristol-Myers Squibb.

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Authors and Affiliations

  1. Department of Pediatrics, H8-270, Emma Children’s Hospital, Amsterdam Medical Centre, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands

    Femke H. M. Prince

  2. Department of Pediatrics/Pediatric Rheumatology, Sophia Children’s Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands

    Lisette W. A. van Suijlekom-Smit

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  1. Femke H. M. Prince
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Correspondence to Femke H. M. Prince.

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Prince, F.H.M., van Suijlekom-Smit, L.W.A. Cost of Biologics in the Treatment of Juvenile Idiopathic Arthritis: A Factor not to be Overlooked. Pediatr Drugs 15, 271–280 (2013). https://doi.org/10.1007/s40272-013-0023-7

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