Disease activity-guided dose optimisation of adalimumab and etanercept is a cost-effective strategy compared with non-tapering tight control rheumatoid arthritis care: analyses of the DRESS study

Annals of the Rheumatic Diseases
Wietske KievitAlfons A den Broeder

Abstract

A disease activity-guided dose optimisation strategy of adalimumab or etanercept (TNFi (tumour necrosis factor inhibitors)) has shown to be non-inferior in maintaining disease control in patients with rheumatoid arthritis (RA) compared with usual care. However, the cost-effectiveness of this strategy is still unknown. This is a preplanned cost-effectiveness analysis of the Dose REduction Strategy of Subcutaneous TNF inhibitors (DRESS) study, a randomised controlled, open-label, non-inferiority trial performed in two Dutch rheumatology outpatient clinics. Patients with low disease activity using TNF inhibitors were included. Total healthcare costs were measured and quality adjusted life years (QALY) were based on EQ5D utility scores. Decremental cost-effectiveness analyses were performed using bootstrap analyses; incremental net monetary benefit (iNMB) was used to express cost-effectiveness. 180 patients were included, and 121 were allocated to the dose optimisation strategy and 59 to control. The dose optimisation strategy resulted in a mean cost saving of -€12 280 (95 percentile -€10 502; -€14 104) per patient per 18 months. There is an 84% chance that the dose optimisation strategy results in a QALY loss with a mean QALY loss...Continue Reading

References

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Citations

Apr 25, 2016·Clinical Rheumatology·Tais Freire GalvaoMauricio Gomes Pereira
Mar 4, 2017·Rheumatology and Therapy·Lise M VerhoefAlfons A den Broeder
Aug 29, 2018·Annals of the Rheumatic Diseases·Nathan den BroederAlfons A den Broeder
Jun 28, 2020·Current Rheumatology Reports·Alexandros A DrososParaskevi V Voulgari
Feb 7, 2017·Alimentary Pharmacology & Therapeutics·S Van SteenbergenM Ferrante
Jan 19, 2019·Advances in Rheumatology·Licia Maria Henrique da MotaRina Dalva Neubarth Giorgi
Dec 7, 2018·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Lieven PouillonLaurent Peyrin-Biroulet

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