title: Anti-TNF treatments in rheumatoid arthritis: economic impact of dosage modification.
abstract: Rheumatoid arthritis (RA) is a chronic systemic disease that leads to increases in health system economic burden through direct and indirect costs, including chronic treatment, reduced productivity and premature mortality. Anti-TNF agents have represented a major advance in the treatment of RA. The most commonly used (adalimumab, etanercept and infliximab) have demonstrated their cost-effectiveness at label doses. However, physicians may need to adapt the treatment by increasing the dose when a drug is not effective enough or by reducing it when there is a sustained effectiveness. In a cross-sectional study conducted in our hospital in which information from RA patients treated with anti-TNF drugs under conventional and modified doses were collected, the authors analyzed the costs of the medication in order to estimate the mean patient-year cost, the annual costs related to clinical efficacy and the cost per responder patient to anti-TNF treatment when dosage modification is undertaken in daily clinical practice.
authors.affiliation: Hospital General Universitario Gregorio Marañón, Rheumatology Department, Dr Esquerdo 46, 28007, Madrid, Spain. inma.torre.ortega@googlemail.com
authors.forename: Inmaculada
authors.initials: I
authors.lastname: de la Torre
authors.forename: Lara
authors.initials: L
authors.lastname: Valor
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Nieto
authors.forename: Diana
authors.initials: D
authors.lastname: Hernández-Flórez
authors.forename: Diana
authors.initials: D
authors.lastname: Hernandez
authors.forename: Lina
authors.initials: L
authors.lastname: Martinez
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Gonzalez
authors.forename: Indalecio
authors.initials: I
authors.lastname: Monteagudo
authors.forename: Javier Lopez
authors.initials: JL
authors.lastname: Longo
authors.forename: Maria
authors.initials: M
authors.lastname: Montoro
authors.forename: Luis
authors.initials: L
authors.lastname: Carreño
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D016527:Drug Costs; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept