June 7, 2012
Personalizing Biologic Treatment To Individual Rheumatoid Arthritis Patients Is Cost-Effective
Data presented today at EULAR 2012, the Annual Congress of the European League Against Rheumatism, demonstrates that tailoring biologic treatment to individual patients with rheumatoid arthritis (RA) can reduce total costs by 2,595,557 per 272 patients over 3 years (95 percentile range -2,983,760 to -2,211,755), whilst increasing effectiveness by an average of 3.67 quality-adjusted life years (QALYs). Cost savings were mostly on drug costs.
The Dutch study, which investigated 272 patients with RA starting adalimumab treatment, measured DAS28 HAQ and biologic use over three years. A treatment protocol for personalized care was defined in which EULAR response and adalimumab serum drug level test results at six months determined whether adalimumab treatment was continued or discontinued, dosing was altered or, in case of non-response, another biological treatment was started. Using a patient level Markov model, outcomes in DAS28, HAQ, and biologic use for the personalized care group were simulated and compared to the observed drug use and disease course.
Charlotte Krieckaert from the Jan van Breemen Research Institute, Reade, The Netherlands and lead author of the study stated: "Governments and health authorities around the world are looking to save money by cutting costs and providing reduced access to more expensive treatments. This study demonstrates that with careful monitoring and testing disease activity at six months, costs for RA treatment can be reduced and treatment effectiveness can actually increase."
In total, 2,562,494 was saved on biological drug costs and testing costs amounted to 10,872, resulting in an average incremental cost-effectiveness ratio (ICER) of -707,236 per QALY gained. Personalized care saved costs and was more effective in 77.6% of simulations, but was cost saving and less effective in 22.4%.
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