Impact of etanercept on the costs of rheumatoid arthritis (RA): results from a French observational study.
BACKGROUND
Economical impact of rheumatoid arthritis (RA) has been widely modified thanks to TNF inhibitors. Our study aims to estimate the impact etanercept prescription, in term of health resources consumption, within a regional cohort of French RA patients.


METHODS
The study included 148 RA patients, with a mean follow-up duration of 343 days before and after etanercept initiation. Data were anonymously collected from ERASME database of French Health Insurance in Midi-Pyrénées region. A patient-by-patient microcosting approach was performed.


RESULTS
The average annual cost per patient, attributable to RA, was 2.8 times higher after treatment by etanercept than before (15,148.57euro versus 5248.95euro). We observed a rise in pharmaceutical costs, from 11.7% of direct medical costs before to 69.7% after etanercept initiation (120.12euro versus 9995.23euro). We observed a small decrease particularly for NSAIDs (142.14euro versus 102.21euro) and physiotherapy (286.40euro versus 138.77euro). Attributable act costs and indirect costs did not differ before and after etanercept initiation.


CONCLUSIONS
In this short-term study, initiation of etanercept in RA patients did not come along with a decrease of consumption of health resources. Long-term studies are needed to reveal a potential economical advantage as a consequence of the clinical, structural and functional efficacy of anti-TNF.
Juillard-Condat
Blandine
B
INSERM U558, 37 allée Jules Guesde, 31073 Toulouse Cedex, France. jblandine@caramail.com
Constantin
Arnaud
A
Cambon-Thomsen
Anne
A
Bourrel
Robert
R
Taboulet
Florence
F
D000328:Adult; D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics* / Q000534:rehabilitation; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D000068800:Etanercept; D005260:Female; D005602:France; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000191:economics / Q000706:statistics & numerical data; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept