Adalimumab and Etanercept in the Treatment of Rheumatoid Arthritis and Spondyloarthropathies: Budget Impact Model of Dose Reduction
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Keywords

 Rheumatoid arthritis, Spondyloarthropathies, Budget impact analysis, Adalimumab, Etanercept, Tumour necrosis factor alpha inhibitors.

How to Cite

Alejandro González Álvarez, Manuel Gómez Barrera, Joaquín Borrás Blasco, & Emilio José Giner Serret. (2014). Adalimumab and Etanercept in the Treatment of Rheumatoid Arthritis and Spondyloarthropathies: Budget Impact Model of Dose Reduction . Journal of Pharmacy and Nutrition Sciences, 4(3), 170–176. https://doi.org/10.6000/1927-5951.2014.04.03.1

Abstract

Objective:To assess the financial impact ofspacing out the administration intervals of adalimumab (ADA) and etanercept (ETN) in the treatment of rheumatoid arthritis (RA) and spondyloarthropathies (SAP) in our work setting.
Materials and method:A budget impact model (BIM) was developed to estimate the financial impact ofspacing out the usual administration intervals of ADA 40 mg every 2 weeks and ETN 50 mg weekly (scenario A) to ADA 40 mg every 3 weeks and ETN 50 mg every 2 weeks (scenario B), according to the guidelines and recommendations applied to these studies, specifying the target population, the study perspective, the time frame, and analysing the robustness of the study with a threshold univariate sensitivity analysis.
Results:A total of 71 patients were included in the study.The application of a BIM showed annual savings for ADA and ETN of €19,784 and €38,271, respectively.The net cost, that is, the savings this entailed for the time frame considered (2 years), amounted to €116,110.The sensitivity analysis performed shows that the BIM estimated for the study period was very robust, as the net result in the different scenarios varied very little, remaining negative in the new scenarios.
Conclusions:The BIM developed in the study shows the importance of the role of healthcare professionals in the context of sustainability of the healthcare system, where the model could generate large annual net savings for the different regional healthcare systems.

https://doi.org/10.6000/1927-5951.2014.04.03.1
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References

Griffith J, Carr A. What is the impact of early rheumatoid arthritis on the individual? Best Pract Res Clin Rheumatol 2001; 15(1): 77-90. http://dx.doi.org/10.1053/berh.2000.0127

Khan MA. Update on spondyloarthropathies. Ann Inter Med 2002; 136(12): 896-907. http://dx.doi.org/10.7326/0003-4819-136-12-200206180-00011

Onen F, Akar S, Birlik M, Sari I, Gurler O, Ergor A, et al. Prevalence of ankylosing spondylitis and related spondyloarthritis in an urban area of Izmir, Turkey. Ann Rheumat Dis 2006; 65: 541-2.

Lab. Abbvie Ltd. Summary of product characteristics ofHumira® (adalimumab) [updated 9/2008

Lab. Pfizer Limited. Summary of product characteristics of Enbrel® (etanercept) [updated 2/2010

Lajas C, Abasolo L, Bellajdel B, Hernandez-Garcia C, Carmona L, Vargas E, et al. Costs and predictors of costs in rheumatoid arthritis: A prevalence-based study. Arthrit Rheumatism-Arthrit Care Res 2003; 49(1): 64-70. http://dx.doi.org/10.1002/art.10905

Ruiz-Montesinos MD, Hernandez-Cruz B, Ariza-Ariza R, Carmona L, Ballina J, Navarro-Sarabia F, et al. Cost analysis in a cohort of rheumatoid arthritis patients managed in rheumatology units in Spain. Reumatol Clin 2005; 1(4): 193-9. http://dx.doi.org/10.1016/S1699-258X(05)72744-3

Kobelt G, Sobocki P, Mulero J, Gratacos J, Pocovi A, Collantes-Estevez E. The burden of ankylosing spondylitis in Spain. Value Health 2008; 11(3): 408-15. http://dx.doi.org/10.1111/j.1524-4733.2007.00252.x

Brosa M, Gisbert R, Rodríguez JM, Soto J. Principios, métodos y aplicaciones del análisis de impacto presupuestario en el sector sanitario. Pharmacoeconomics-Spanish Res Articl 2005 (2): 65-78.

Trueman P, Drummond M, Hutton J. Developing guidance for budget impact analysis. Pharmacoeconomics 2001; 19(6): 609-21. http://dx.doi.org/10.2165/00019053-200119060-00001

Orlewska E, Mierzejewski P. Proposal of polish guidelines for conducting financial analysis and their comparison to existing guidance on budget impact in other countries. Value Health 2004; 7(1): 1-10. http://dx.doi.org/10.1111/j.1524-4733.2004.71257.x

Salliot C. Indirect comparisons of the efficacy of biological antirheumatic agents in rheumatoid arthritis in patients with an inadequate response to conventional disease-modifying antirheumatic drugs or to an anti-tumour necrosis factor agent: a meta-analysis. Ann Rheumat Dis 2011; 70(3): 660-665.

Schmitz S, Adams R, Walsh CD, Barry M, FitzGerald O. A mixed treatment comparison of the efficacy of anti-TNF agents in rheumatoid arthritis for methotrexate non-responders demonstrates differences between treatments: a Bayesian approach. Ann Rheumat Dis 2012; 71(2): 225-30. http://dx.doi.org/10.1136/annrheumdis-2011-200228

Mandema JW, Salinger DH, Baumgartner SW, Gibbs MA. A Dose-Response Meta-Analysis for Quantifying Relative Efficacy of Biologics in Rheumatoid Arthritis. Clin Pharmacol Therapeut 2011; 90(6): 828-35. http://dx.doi.org/10.1038/clpt.2011.256

Kirchhoff TD, Mittendorf T, Schmidt RE, Jablonka A, Merkesdal S. Cost-effectiveness of TNF-alpha inhibition in active ankylosing spondylitis: a systematic appraisal of the literature. Expert Rev Pharmacoeconomics Outcomes Res 2012; 12(3): 307-17. http://dx.doi.org/10.1586/erp.12.19

Cortesi PA, Scalone L, D'Angiolella L, Belisari A, Fusco F, Olivieri I, et al. Systematic literature review on economic implications and pharmacoeconomic issues of psoriatic arthritis. Clin Exper Rheumatol 2012; 30(4 Suppl 73): 126-31.

Carter CT, Changolkar AK, Scott McKenzie R. Adalimumab, etanercept, and infliximab utilization patterns and drug costs among rheumatoid arthritis patients. J Med Econom 2012; 15(2): 332-9. http://dx.doi.org/10.3111/13696998.2011.649325

Bullano MF, McNeeley BJ, Yu YF, Quimbo R, Burawski LP, Yu EB, et al. Comparison of costs associated with the use of etanercept, infliximab, and adalimumab for the treatment of rheumatoid arthritis. Managed Care Interf 2006; 19(9): 47-53.

Wu E, Chen L, Birnbaum H, Yang E, Cifaldi M. Cost of care for patients with rheumatoid arthritis receiving TNF-antagonist therapy using claims data. Curr Med Res Opin 2007; 23(8): 1749-59. http://dx.doi.org/10.1185/030079907X210615

Rubio-Terres C, Ordovas Baines JP, Pla Poblador R, Martinez Nieto C, Sanchez Garre MJ, Rosado Souviron MA, et al. [Use and cost of biological disease-modifying anti-rheumatic drugs in Spain (PRAXIS study)

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Copyright (c) 2014 Alejandro González Álvarez, Manuel Gómez Barrera, Joaquín Borrás Blasco , Emilio José Giner Serret