title: Similar clinical outcomes in rheumatoid arthritis with more versus less expensive treatment strategies. Observational data from two rheumatology clinics.
abstract: OBJECTIVE
  Selection of efficacious medications for rheumatoid arthritis (RA) has tremendously increased over a decade including new costly biologic agents and inexpensive conventional anti-rheumatic drugs, used in combinations for more efficacy. Treatments aim at remission or at least low disease activity. Our objective was to study whether treatment target is reached and to what cost, in patients with RA in two Nordic rheumatology clinics.
  
  
  METHODS
  Cross sectional observational clinical data of all patients with RA seen in 2010 in two Nordic county hospital rheumatology units: Kristiansand, Norway and Jyväskylä, Finland, which both serve a population of about 275,000. Measures included patient demographic measures, clinical characteristics, disease activity, functional status, and treatments. Annual costs of medications to the society were calculated per 100 patients, using an assumption that a patient is taking current medications for one year.
  
  
  RESULTS
  Patient populations from Kristiansand and Jyväskylä were similar according to age, gender, disease duration, and prevalence of RF and CCP. Disease activity was low and patients' functional status well reserved in both clinics. Almost twice as many patients in Kristiansand than in Jyväskylä (33% vs. 17%) used biologic agents. A combination of conventional anti-rheumatic drugs was currently used by <1% of patients in Kristiansand and by 37% of patients in Jyväskylä. Estimated annual costs of medications per 100 patients were €508,000 in Kristiansand and €280,000 in Jyväskylä.
  
  
  CONCLUSIONS
  Treatment target of remission/low disease activity and good functional status can be reached in RA using expensive and less-expensive anti-rheumatic drugs.
authors: Jyväskylä Central Hospital, Jyväskylä, Finland. tuulikki.sokka@ksshp.fi
authors: Tuulikki
authors: T
authors: Sokka
authors: Glenn
authors: G
authors: Haugeberg
authors: Juha
authors: J
authors: Asikainen
authors: Inger Johanne
authors: IJ
authors: Widding Hansen
authors: Arto
authors: A
authors: Kokko
authors: Tuomas
authors: T
authors: Rannio
authors: Dag Magnar
authors: DM
authors: Soldal
authors: Pekka
authors: P
authors: Hannonen
mesh_terms: D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000191:economics*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents