title: Economical aspect of biological therapy in inflammatory conditions in Hungary.
abstract: BACKGROUND
  There has been a burst in the use of biological therapies in the past decade resulting in increasing costs. In 2006 - 2010 the following biological agents were available in Hungary: adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, and ustekinumab. All biological agents except rituximab were first line therapies; rituximab was a second line option in rheumatoid arthritis.
  
  
  METHODS
  Data of the financing system related to health care services from the data warehouse of the Hungarian National Health Insurance Fund were in inflammatory conditions. Our analysis showed a constant increase in number of patients and overall cost of biological therapy as well as annual cost of biological agents. Distribution of first choice of biological therapy was compared in different diseases. Time from diagnosis to start of biological therapy showed relatively high deviations.
  
  
  CONCLUSIONS
  In order to achieve both health benefit and cost-effectiveness it is crucial that biological therapy is initiated early enough in the course of the disease, after the failure of non-biological therapies. Health authorities in close collaboration with clinical decision-makers should ensure that early detection of the disease and early initiation of appropriate therapies-including non-biological and biological therapies-are carried out in the health care systems.
authors.affiliation: Department of Medical Expertise, Clinical Auditing and Analysis, National Health Insurance Fund Administration, Váci út 73./A, 1139 Budapest, Hungary. laki_jutka@yahoo.com
authors.forename: Judit
authors.initials: J
authors.lastname: Laki
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mónok
authors.forename: Mihály
authors.initials: M
authors.lastname: Pálosi
authors.forename: József Zs
authors.initials: JZ
authors.lastname: Gajdácsi
mesh_terms: D001691:Biological Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D006801:Humans; D006814:Hungary; D007249:Inflammation / Q000175:diagnosis / Q000191:economics* / Q000628:therapy