Trial-based cost-effectiveness of abatacept for rheumatoid arthritis patients in Italy.
BACKGROUND
Rheumatoid arthritis (RA) is a chronic, inflammatory disorder leading to disability and reduced quality of life. Effective treatment is a significant economic burden on the Italian healthcare system. Economic models in RA are commonly based on indirect treatment comparisons.


METHODS
This study assessed the cost-effectiveness of abatacept relative to adalimumab for RA in Italy based on a head-to-head trial by means of a cost-consequence analysis.


RESULTS
Health benefits based on the most stringent efficacy criteria were in favor of abatacept compared to adalimumab. Rates for more costly adverse events were higher for adalimumab compared to abatacept, which was reflected in the lower costs for abatacept (-€237,246 or -€237per patient).


CONCLUSIONS
The health economic value of abatacept compared with adalimumab from the perspective of the Italian NHS depends on the choice of health outcome. Health gains with abatacept were generally based on more stringent criteria and lower total costs.
a Mapi Group , Houten , Netherlands.
J
J
Gaultney
b Ospedale S.Giovanni di Dio Firenze , Florence , Italy.
M
M
Benucci
c SIHS Health Economics Consulting , Turin , Italy.
S
S
Iannazzo
d Bristol-Myers Squibb , Rome , Italy.
C
C
Nappi
a Mapi Group , Houten , Netherlands.
K
K
Sion
e Bristol-Myers Squibb , Madrid , Spain.
F J
FJ
Sabater
D000069594:Abatacept / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D000068879:Adalimumab / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics; D011788:Quality of Life; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D000069594:Abatacept; D000068879:Adalimumab
Biologic; Italy; cost–consequence; disease-modifying anti-rheumatic drugs; rheumatoid arthritis