title: Cost-efficacy of biologic therapies for psoriatic arthritis from the perspective of the Taiwanese healthcare system.
abstract: BACKGROUND
  Biologic therapies are more effective but more costly than conventional therapies in treating psoriatic arthritis.
  
  
  OBJECTIVE
  To evaluate the cost-efficacy of etanercept, adalimumab and golimumab therapies in treating active psoriatic arthritis in a Taiwanese setting.
  
  
  METHODS
  We conducted a meta-analysis of randomized placebo-controlled trials to calculate the incremental efficacy of etanercept, adalimumab and golimumab, respectively, in achieving Psoriatic Arthritis Response Criteria (PsARC) and a 20% improvement in the American College of Rheumatology score (ACR20). The base, best, and worst case incremental cost-effectiveness ratios (ICERs) for one subject to achieve PsARC and ACR20 were calculated.
  
  
  RESULTS
  The annual ICER per PsARC responder were US$27 047 (best scenario US$16 619; worst scenario US$31 350), US$39 339 (best scenario US$31 846; worst scenario US$53 501) and US$27 085 (best scenario US$22 716; worst scenario US$33 534) for etanercept, adalimumab and golimumab, respectively. The annual ICER per ACR20 responder were US$27 588 (best scenario US$20 900; worst scenario US$41 800), US$39 339 (best scenario US$25 236; worst scenario US$83 595) and US$33 534 (best scenario US$27 616; worst scenario US$44 013) for etanercept, adalimumab and golimumab, respectively.
  
  
  CONCLUSIONS
  In a Taiwanese setting, etanercept had the lowest annual costs per PsARC and ACR20 responder, while adalimumab had the highest annual costs per PsARC and ACR responder.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chiayi, Taiwan.
authors.forename: Tsong-Shing
authors.initials: TS
authors.lastname: Yang
authors.affiliation: Department of Dermatology and Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. chingchi@cgmh.org.tw, chingchichi@gmail.com.|College of Medicine, Chang Gung University, Taoyuan, Taiwan. chingchi@cgmh.org.tw, chingchichi@gmail.com.
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Chi
authors.affiliation: Department of Dermatology, Far Eastern Memorial Hospital, Banciao, New Taipei, Taiwan.
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chiayi, Taiwan.
authors.forename: Jing-Chi
authors.initials: JC
authors.lastname: Lin
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chiayi, Taiwan.
authors.forename: Ko-Ming
authors.initials: KM
authors.lastname: Lin
mesh_terms: D000068879:Adalimumab / Q000191:economics / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000276:immunology; D001688:Biological Products / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D016527:Drug Costs; D000068800:Etanercept / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D001688:Biological Products; C529000:golimumab; D000068879:Adalimumab; D000068800:Etanercept
keywords: adalimumab; cost analysis; etanercept; golimumab; psoriatic arthritis