title: Etanercept does not essentially increase the total costs of the treatment of refractory juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To assess the costs of adding etanercept to the prevailing drug therapy for a one-year period in a group of 31 children with juvenile idiopathic arthritis (JIA) whose disease was refractory to conventional disease modifying antirheumatic drugs.
  
  
  METHODS
  The changes in total costs were retrospectively collected from medical records and by interviewing parents 6 months before the initiation of etanercept treatment and during a 12-month followup divided into 3-month periods.
  
  
  RESULTS
  Direct median costs increased during the first 3 months after the introduction of etanercept, but decreased later during the followup. The estimated median direct costs per patient increased by 4200 US dollars per year, and the indirect costs were reduced by 50%, i.e., 1700 US dollars . The estimated median total cost per patient was increased by about 2700 US dollars per year (10%).
  
  
  CONCLUSIONS
  After combining etanercept with the prevailing treatment, the total costs of refractory JIA calculated per year were only slightly higher than those of traditional therapy. This finding must be evaluated in light of the reduced inflammatory activity of the joint disease and the probable reduction of lifetime pain and disability produced by the disease.
authors.affiliation: Rheumatism Foundation Hospital, Heinola, Finland. jarkko.haapasaari@reuma.fi
authors.forename: Jarkko
authors.initials: J
authors.lastname: Haapasaari
authors.forename: Hannu J
authors.initials: HJ
authors.lastname: Kautiainen
authors.forename: Heikki A
authors.initials: HA
authors.lastname: Isomäki
authors.forename: Markku
authors.initials: M
authors.lastname: Hakala
mesh_terms: D000293:Adolescent; D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000068800:Etanercept; D005387:Finland; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics* / Q000627:therapeutic use*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept