Modeling and cost-effectiveness analysis of etanercept in adults with rheumatoid arthritis in Japan: a preliminary analysis

Modern Rheumatology
Makoto TannoAtsuo Nakajima

Abstract

The tumor necrosis factor (TNF) antagonist etanercept is an antirheumatic agent which was approved by Japanese regulatory authorities in January 2005. In Japan, the cost-effectiveness of this therapy for patients with rheumatoid arthritis (RA) has not previously been evaluated. This study models the cost-utility of etanercept in comparison with standard therapy with disease-modifying antirheumatic drugs (DMARDs) among adult Japanese RA patients who have failed a previous course of the DMARD bucillamine. A Markov model with 6-month cycles was constructed to compare two therapeutic strategies: etanercept versus standard therapy. For each cycle, one of three options was possible: a patient could (i) remain on current therapy if American College of Rheumatology criteria for 20% clinical improvement (ACR20) were achieved, (ii) switch to another drug in the therapeutic pathway if ACR20 was not achieved or if side effects severe enough to cause treatment discontinuation occurred, or (iii) they could die. The therapeutic pathway for the etanercept strategy was etanercept, methotrexate (MTX), sulfasalazine (SSZ), combination therapy (MTX + SSZ) and, finally, no DMARD. The pathway for standard therapy was identical except the initial the...Continue Reading

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Citations

Aug 29, 2009·Rheumatology·Lai-Shan TamEdmund K Li
Sep 4, 2014·Current Rheumatology Reports·Jonathan ToshRon Akehurst
Jan 21, 2010·Modern Rheumatology·Shumpei YokotaUNKNOWN Pediatric Rheumatology Association of Japan
Dec 12, 2012·Best Practice & Research. Clinical Rheumatology·Nicole W TsaoCarlo A Marra
Dec 17, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Becky Pennington, Sarah Davis
Jul 26, 2015·Health Economics Review·Stefan Scholz, Thomas Mittendorf

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