Standard starting treatment for rheumatoid arthritis [RA] includes methotrexate as a disease-modifying antirheumatic drug [DMARD] and a non-steroidal anti-inflammatory drug [NSAID] or low-dose prednisone. Although these drugs work to some extent, they rarely mention remission.
Tumor necrosis factor inhibitors such as Enbrel, Humira and Remicade have revolutionized our RA approach and enabled rheumatologists to relieve patients.
The high cost of biologics has taken "pharmacoeconomics" considerations as a factor in the treatment of patients with rheumatoid arthritis. A growing body of data confirms the substantial cost impact of various arthritic conditions. For TNF inhibitors, clinical effects need to be considered in the assessment of their value.
In RA, more and more data addresses the potential cost benefits of TNF inhibitors. Due to its significant clinical efficiency, it appears that TNF inhibitors may have increased cost efficiency in RA.
Much of the data based on this is from the follow-up of patients who have participated in clinical trials of these drugs over the past decade. In general, changes in health status, using specific quantitative indicators of performance of daily living activities, provide evidence of cost-effectiveness.
The use of anti-TNF drugs and then measuring their effects on function has provided the ability to define response levels to treatment based on quality-adjusted life years [QALYs] obtained.
Many studies have shown that the working conditions of treatment have improved.
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Other studies have begun to explore the impact of TNF inhibitor treatment on employability; in one study, this treatment significantly improved employability and reduced the number of days lost.
In addition, ongoing research is developing models to compare the outcomes of patients who are able to perform productive work with the outcomes of progressive disease and paralysis. Patients who are unable to obtain anti-TNF drugs and who are paralyzed cannot become active producers of the economy. Most importantly, there will be a negative impact on the economy in terms of the dollar needed for the patient's health care support.
Unfortunately, insurance companies that set obstacles to the acquisition of these drugs have a very short-sighted view of this situation. It is hoped that further research will document the value of society and individuals in maintaining productivity and improving the quality of life, which will better change this situation.
Orignal From: Is a new biologic drug for rheumatoid arthritis worth it?
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