Cost-effectiveness of abatacept, tocilizumab and TNF-inhibitors compared with rituximab as second-line biologic drug in rheumatoid arthritis

• DOI: 10.1371/journal.pone.0220142
• Publication Date: 2019-07-24T17:41:59Z
• Authors: Saara Huoponen; Kalle J. Aaltonen; Jaana Viikinkoski; Jarno Rutanen; Heikki Relas; Kirsi Taimen; Kari Puolakka; Dan Nordström; Marja Blom
• Keywords: Abatacept; Tocilizumab; TNF inhibitor

Objectives The objective of this study was to evaluate the cost-effectiveness abatacept, tocilizumab, and tumor necrosis factor (TNF) inhibitors as compared with rituximab in Finnish rheumatoid arthritis patients, who have previously been treated TNF inhibitors. Methods A patient-level simulation model developed predict costs outcomes associated four biological drugs (abatacept, inhibitors) treatment arthritis. Following lack efficacy or adverse events, patients were switched another drug until all options exhausted. After that, assumed receive a 6th line death. patients' baseline characteristics regression models used based on observational data from National Register for Biological Treatments Finland. Direct comprised costs, administration switching, outpatient inpatient care, while indirect included disability pension sick leaves due Several subgroup deterministic sensitivity analyses conducted. Results Drug lowest rituximab, but when switching included, Abatacept highest whereas healthcare costs. In total, had direct amount quality-adjusted life years (QALY) gained ranged 9.405 9.661 inhibitors, tocilizumab dominant comparison RTX. Conclusions lower higher QALYs than therefore, they rituximab. As QALYs, most cost-effective option.