June 7, 2012 in
Arthritis & Rheumatism Berlin, Germany, June 7 2012: Data presented today
at EULAR 2012, the Annual Congress of the European League Against Rheumatism,
demonstrates that tailoring biologic treatment to individual patients with
rheumatoid arthritis (RA) can reduce total costs by €2,595,557 per 272 patients over 3 years (95 percentile range -€2,983,760
to -€2,211,755), whilst increasing effectiveness by an average of 3.67
quality-adjusted life years (QALYs)*. Cost savings were mostly on drug costs. The
Dutch study, which investigated 272 patients with RA starting adalimumab
treatment, measured DAS28** HAQ*** and biologic use over three years. A
treatment protocol for personalised care was defined in which EULAR****
response and adalimumab serum drug level test results at six months determined
whether adalimumab treatment was continued or discontinued, dosing was altered
or, in case of non-response, another biological treatment was started. Using a
patient level Markov model, outcomes in DAS28, HAQ, and biologic use for the
personalised care group were simulated and compared to the observed drug use
and disease course. Charlotte Krieckaert from the Jan van Breemen Research
Institute, Reade, The Netherlands and lead author of the study stated: "Governments
and health authorities around the world are looking to save money by cutting
costs and providing reduced access to more expensive treatments. This study
demonstrates that with careful monitoring and testing disease activity at six
months, costs for RA treatment can be reduced and treatment effectiveness can
actually increase." In total, €2,562,494 was saved on biological drug
costs and testing costs amounted to €10,872, resulting in an average
incremental cost-effectiveness ratio (ICER)***** of -€707,236 per QALY gained.
Personalised care saved costs and was more effective in 77.6% of simulations,
but was cost saving and less effective in 22.4%. More information: Abstract
Number: OP0149 *QALY (Quality-adjusted life year) is a measure of how many extra
months or years of life of a reasonable quality a person might gain as a result
of treatment. Various factors are considered in this measurement, including,
the level of pain the person is in, their mobility and their general mood. The
quality of life rating can range from negative values below 0 (worst possible
health) to 1 (the best possible health). **DAS28 (Disease Activity Score) is an
index used by physicians to measure how active an individual's RA is. It
assesses number of tender and swollen joints (out of a total of 28), the
erythrocyte sedimentation rate (ESR, a blood marker of inflammation), and the
patient's 'global assessment of global health'. A higher score indicates more
active disease. ***HAQ DI (Health Assessment Questionnaire – Disease Index) is
a patient questionnaire that measures function and health-related quality of
life through measuring a patient's ability to perform everyday tasks. ****EULAR
response criteria were developed to measure individual response in clinical
trials. The EULAR response criteria classify individual patients as non-,
moderate, or good responders, dependent on the extent of change and the level
of disease activity reached. *****ICER (Incremental cost-effectiveness ratio)
is an equation used to provide a practical approach to decision making
regarding health interventions and is typically used in cost-effectiveness
analysis. ICER is the ratio of the change in costs to incremental benefits of a
therapeutic intervention or treatment. Provided by European League Against
Rheumatism
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