Economic evaluation of low-dose SKA cytokines in patients with rheumatoid arthritis in maintaining low disease activity or remission
Valutazione economica delle citochine a basso dosaggio nel trattamento di mantenimento in pazienti con artrite reumatoide a bassa attività di malattia o in remissione.
Introduction. The administration of low-dose SKA cytokines allows to maintain remission or low disease activity in patients with rheumatoid arthritis. This analysis aims to estimate the maintenance treatment cost of low-dose SKA cytokines versus DMARDs in patients with rheumatoid arthritis.
Methods and Results. Rather than evaluating the cost-effectiveness of individual therapeutic agents, it becomes recommendable for decision-makers to identify an optimal sequencing of such agents. A one-year cost consequence analysis (CCA) was conducted, comparing two alternative strategies to maintain remission or low disease activity in patients with rheumatoid arthritis: i) first line with low-dose SKA cytokines and second line with antitumor necrosis factor-α (TNF-α), ii) first line with DMARDs and second line with TNF-α. The CCA was conducted from the perspective of the Italian National Health Service (iNHS). Only direct medical costs (drugs cost) were considered. We performed a sensitivity analysis to test the robustness of the results. The sequence using cytokines in first line showed the lower mean annual cost of treatment: the mean annual cost per patient was €1,280.96 with cytokines and €1,987.21 with DMARDs. Sensitivity analyses confirmed the base case result.
Conclusion. From the iNHS’s perspective low-dose, SKA cytokines, as first line treatment appears a cost-saving strategy to maintain remission or low disease activity in patients with rheumatoid arthritis.
Copyright (c) 2020 Roberto Ravasio, Alberto Migliore
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