title: [Adalimumab versus etanercept in the treatment of active rheumatoid arthritis: cost-effectiveness analysis].
abstract: OBJECTIVE
  To assess the effectiveness and efficiency of the two alternatives mainly used in our area, etanercept (ETN) and adalimumab (ADA), for the treatment of rheumatoid arthritis (RA) patients under real clinical practice.
  
  
  METHODS
  We performed a retrospective observational study, where the time horizon was 12 months referred to the year 2012. We analyzed the characteristics of patients, and the effectiveness and efficiency of ETN and ADA in our study population.
  
  
  METHODS
  patients over 18 years, diagnosed with RA treated at the outpatient clinic of the Rheumatology Health Sector of Teruel. We determined the mean decrease in DAS28 value (DAS28r) of each drug and we defined as a unit of effectiveness in pharmacoeconomic study, a DAS28 value at baseline (DAS28a) less than 3.2 points and DAS28r greater than 1.2 points. As parameter to determine the cost-effectiveness of both alternatives we used net health benefits (NHB).
  
  
  RESULTS
  The average value of DAS28a was 2,25 and 2,72 points for ETN and ADA respectively, with a value of DAS28r 1,01 points higher for ETN, although not statistically significant (p> 0.05). NHB obtained a value of -0.121, 95% CI (-0.951 to 0.709).
  
  
  CONCLUSIONS
  Both alternatives are effective in the treatment of RA, although it seems to be a trend in favor of ETN in cost-effectiveness degree.
authors.forename: A
authors.initials: A
authors.lastname: González Álvarez
authors.forename: M
authors.initials: M
authors.lastname: Gómez Barrera
authors.forename: J
authors.initials: J
authors.lastname: Borrás Blasco
authors.forename: E J
authors.initials: EJ
authors.lastname: Giner Serrer
mesh_terms: D000068879:Adalimumab; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data; D000068800:Etanercept; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D018401:Sample Size; D012720:Severity of Illness Index; D013030:Spain; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068879:Adalimumab; D000068800:Etanercept