[Health-economic assessment of combination therapy for rheumatoid arthritis with methotrexat and etanercept based on the TEMPO Study].
BACKGROUND
The TEMPO study has shown that the combination of etanercept and methotrexat (MTX) in the treatment of rheumatoid arthritis (RA) is superior to monotherapy. It further suggested that remission of RA is a realistic treatment objective. A health-economic assessment of the combination needs to demonstrate the suitability of the combination for daily clinical practice taking economic aspects into consideration.


METHODS
For the 686 patients in the TEMPO study, a re-analysis was carried out in the form of a Monte-Carlo-Markov-Chain simulation. Study types were cost-effectiveness analysis and cost-utility analysis. Comparators were combined etanercept and MTX vs. MTX alone; the perspective was that of society as a whole.


RESULTS
The incremental cost-effectiveness ratio of the combination is <euro>21,300 per life year in remission as compared with MTX alone. The incremental cost-utility ratio of the combination is <euro>38,700 per quality-adjusted life year.


CONCLUSIONS
Both health-economic parameters suggest to adopt the combination therapy into daily clinical practice of RA patients.
Schulze-Koops
H
H
Rheumaeinheit, Klinikum der Ludwig-Maximilians-Universität München, Pettenkoferstr. 8a, 80336, München, Deutschland. hendrik.schulze-koops@med.uni-muenchen.de
Deeg
M
M
Runge
C
C
Volmer
T
T
Brecht
J G
JG
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005858:Germany; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics* / Q000627:therapeutic use*; D008727:Methotrexate / Q000191:economics* / Q000627:therapeutic use*; D008875:Middle Aged; D009010:Monte Carlo Method; D009313:National Health Programs / Q000191:economics*; D017063:Outcome Assessment, Health Care; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D008727:Methotrexate