title: Cost-effectiveness modeling of abatacept versus other biologic agents in DMARDS and anti-TNF inadequate responders for the management of moderate to severe rheumatoid arthritis.
abstract: To assess the cost-effectiveness of abatacept compared to different biologic treatment strategies for moderate to severe rheumatoid arthritis based on current medical practices in Canada. A model was constructed to assess the cost-effectiveness of various biologic treatments over a 2-year time horizon, using two effectiveness endpoints: "low disease activity state" (LDAS) and "remission". Abatacept, as first biologic agent after an inadequate response to DMARDs, provides greater treatment success rate for achieving LDAS (29.4% versus 15.6%) and remission (14.8% versus 5.2%), and appears significantly more cost-effective compared to the sequential use of anti-TNF agents (p<0.001). Abatacept, as second biologic agent after an inadequate response to one anti-TNF agent, provides greater treatment success rate for achieving LDAS (17.1% versus 10.2%) and remission (7.4% versus 3.9%) and appears significantly more cost-effective compared to the sequential use of anti-TNF agents (p<0.001). Abatacept is a cost-effective strategy in patients with an inadequate response to DMARDs or to one anti-TNF agent.
authors.affiliation: University of Alberta, Edmonton, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Russell
authors.forename: Ariel
authors.initials: A
authors.lastname: Beresniak
authors.forename: Louis
authors.initials: L
authors.lastname: Bessette
authors.forename: Boulos
authors.initials: B
authors.lastname: Haraoui
authors.forename: Proton
authors.initials: P
authors.lastname: Rahman
authors.forename: Carter
authors.initials: C
authors.lastname: Thorne
authors.forename: Ross
authors.initials: R
authors.lastname: Maclean
authors.forename: Danielle
authors.initials: D
authors.lastname: Dupont
mesh_terms: D000069594:Abatacept; D018501:Antirheumatic Agents / Q000191:economics* / Q000494:pharmacology*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006801:Humans; D018796:Immunoconjugates / Q000191:economics* / Q000494:pharmacology*; D008875:Middle Aged; D008962:Models, Theoretical; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D018501:Antirheumatic Agents; D018796:Immunoconjugates; D014409:Tumor Necrosis Factor-alpha; D000069594:Abatacept