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10.1007/s00296-017-3739-9

http://scihub22266oqcxt.onion/10.1007/s00296-017-3739-9
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suck abstract from ncbi


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pmid28560470
      Rheumatol+Int 2017 ; 37 (7 ): 1111-1123
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  • Cost per response for abatacept versus adalimumab in rheumatoid arthritis by ACPA subgroups in Germany, Italy, Spain, US and Canada #MMPMID28560470
  • Weijers L ; Baerwald C ; Mennini FS ; Rodríguez-Heredia JM ; Bergman MJ ; Choquette D ; Herrmann KH ; Attinŕ G ; Nappi C ; Merino SJ ; Patel C ; Mtibaa M ; Foo J
  • Rheumatol Int 2017[Jul]; 37 (7 ): 1111-1123 PMID28560470 show ga
  • Rheumatoid arthritis (RA) is a chronic inflammatory disorder leading to disability and reduced quality of life. Effective treatment with biologic DMARDs poses a significant economic burden. The Abatacept versus Adalimumab Comparison in Biologic-Naďve RA Subjects with Background Methotrexate (AMPLE) trial was a head-to-head, randomized study comparing abatacept in serum anti-citrullinated protein antibody (ACPA)-positive patients, with increasing efficacy across ACPA quartile levels. The aim of this study was to evaluate the cost per response accrued using abatacept versus adalimumab in ACPA-positive and ACPA-negative patients with RA from the health care perspective in Germany, Italy, Spain, the US and Canada. A cost-consequence analysis (CCA) was designed to compare the monthly costs per responding patient/patient in remission. Efficacy, safety and resource use inputs were based on the AMPLE trial. A one-way deterministic sensitivity analysis (OWSA) was also performed to assess the impact of model inputs on the results for total incremental costs. Cost per response in ACPA-positive patients favoured abatacept compared with adalimumab (ACR20, ACR90 and HAQ-DI). Subgroup analysis favoured abatacept with increasing stringency of response criteria and serum ACPA levels. Cost per remission (DAS28-CRP) favoured abatacept in ACPA-negative patients, while cost per CDAI and SDAI favoured abatacept in ACPA-positive patients. Abatacept was consistently favoured in ACPA-Q4 patients across all outcomes and countries. Cost savings were greater with abatacept when more stringent response criteria were applied and also with increasing ACPA levels, which could lead to a lower overall health care budget impact with abatacept compared with adalimumab.
  • |*Drug Costs [MESH]
  • |Abatacept/adverse effects/*economics/*therapeutic use [MESH]
  • |Adalimumab/adverse effects/*economics/*therapeutic use [MESH]
  • |Anti-Citrullinated Protein Antibodies/*blood [MESH]
  • |Antirheumatic Agents/adverse effects/*economics/*therapeutic use [MESH]
  • |Arthritis, Rheumatoid/blood/*drug therapy/*economics/immunology [MESH]
  • |Biomarkers/blood [MESH]
  • |Canada [MESH]
  • |Clinical Decision-Making [MESH]
  • |Cost Savings [MESH]
  • |Cost-Benefit Analysis [MESH]
  • |Decision Support Techniques [MESH]
  • |Europe [MESH]
  • |Humans [MESH]
  • |Models, Economic [MESH]
  • |Remission Induction [MESH]
  • |Time Factors [MESH]
  • |Treatment Outcome [MESH]


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