Pharmacoeconomics of long-term treatment of rheumatoid arthritis

Expert Opinion on Pharmacotherapy
Barbara BlumenauerPeter Tugwell

Abstract

Rheumatoid arthritis affects ~ 1% of the population. It is associated with pain, deformity, decreased quality of life and disability that in turn affects patients' ability to work. A variety of disease-modifying antirheumatic drugs are available to control the disease activity of rheumatoid arthritis. The goal of treatment is to improve patients' quality of life and prevent joint destruction. This paper reviews both the clinical aspects of frequently prescribed disease-modifying antirheumatic drugs and the available cost-effectiveness information. Clinical evidence supports the effectiveness of methotrexate, etanercept, infliximab, gold, hydroxychloroquine, leflunomide, sulfasalazine, penicillamine, cyclosporin, azathioprine and corticosteroids. The last four of these are associated with greater toxicity and are only used if less toxic drugs are ineffective. The lack of published economic evaluations of disease-modifying antirheumatic drugs highlights the need for such studies to allow efficacious and cost-effective drugs to be used to prevent the long-term complications of uncontrolled rheumatoid arthritis.

References

Mar 28, 1985·The New England Journal of Medicine·M E WeinblattD E Trentham
Jan 1, 1974·Annals of Internal Medicine·J W SiglerW R McCrum
Oct 1, 1994·Arthritis and Rheumatism·M E WeinblattE Gall
Apr 1, 1996·Seminars in Arthritis and Rheumatism·A KavanaughR Jain
Nov 30, 2000·The New England Journal of Medicine·J M BathonB K Finck
Sep 11, 2001·PharmacoEconomics·S E GabrielL W Moreland

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