title: [Cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of rheumatoid arthritis].
abstract: OBJECTIVE
  to conduct cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of moderate or severe rheumatoid arthritis in patients with previous unresponse to immune selective anti-inflammatory derivatives failure.
  
  
  METHODS
  a pharmacoeconomic model based on decision analysis to assess the clinical outcome after giving etanercept, infliximab, adalimumab or tocilizumab to treat moderate or severe rheumatoid arthritis was employed. Effectiveness of medications was assessed with improvement rates of 20 % or 70 % of the parameters established by the American College of Rheumatology (ACR 20 and ACR 70).
  
  
  RESULTS
  the model showed that etanercept had the most effective therapeutic response rate: 79.7 % for ACR 20 and 31.4 % for ACR 70, compared with the response to other treatments. Also, etanercept had the lowest cost ($149,629.10 per patient) and had the most cost-effective average ($187,740.40 for clinical success for ACR 20 and $476,525.80 for clinical success for ACR 70) than the other biologic therapies.
  
  
  CONCLUSIONS
  we demonstrated that treatment with etanercept is more effective and less expensive compared to the other drugs, thus making it more efficient therapeutic option both in terms of means and incremental cost-effectiveness ratios for the treatment of rheumatoid arthritis.
authors.affiliation: Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México "Federico Gómez," Distrito Federal, México, Mexico. guillermosalinas@yahoo.com.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Salinas-Escudero
authors.forename: Juan
authors.initials: J
authors.lastname: Vargas-Valencia
authors.forename: Erika Gabriela
authors.initials: EG
authors.lastname: García-García
authors.forename: Emilio
authors.initials: E
authors.lastname: Munciño-Ortega
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Galindo-Suárez
mesh_terms: D018501:Antirheumatic Agents / Q000191:economics* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001691:Biological Therapy; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics* / Q000627:therapeutic use*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept
keywords: and cost analysis; arthritis, rheumatoid; artritis reumatoide; costos y análisis de costo; economics, pharmaceutical; economía farmacéutica