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Cost-effectiveness modeling of abatacept versus other biologic agents in DMARDS and anti-TNF inadequate responders for the management of moderate to severe rheumatoid arthritis

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Abstract

To assess the cost-effectiveness of abatacept compared to different biologic treatment strategies for moderate to severe rheumatoid arthritis based on current medical practices in Canada. A model was constructed to assess the cost-effectiveness of various biologic treatments over a 2-year time horizon, using two effectiveness endpoints: “low disease activity state” (LDAS) and “remission”. Abatacept, as first biologic agent after an inadequate response to DMARDs, provides greater treatment success rate for achieving LDAS (29.4% versus 15.6%) and remission (14.8% versus 5.2%), and appears significantly more cost-effective compared to the sequential use of anti-TNF agents (p < 0.001). Abatacept, as second biologic agent after an inadequate response to one anti-TNF agent, provides greater treatment success rate for achieving LDAS (17.1% versus 10.2%) and remission (7.4% versus 3.9%) and appears significantly more cost-effective compared to the sequential use of anti-TNF agents (p < 0.001). Abatacept is a cost-effective strategy in patients with an inadequate response to DMARDs or to one anti-TNF agent.

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Acknowledgment

We are grateful to Dr Claire Bombardier, MD, FRCPC, Mount Sinai Hospital, University of Toronto (Canada) for providing the data on the Ontario cohort for the calculation of the cost per DAS categories.

Disclosures

Anthony Russell, Ariel Beresniak, Louis Bessette, Boulos Haraoui, Proton Rahman and Carter Thorne have received fees and honorarium to attend Steering Committee meetings and to defray travel expenses reimbursement from Bristol-Myers Squibb.

Ross Maclean and Danielle Dupont are employees of Bristol-Myers Squibb.

Source of funding

The work has been sponsored by Bristol-Myers Squibb International.

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Correspondence to Ariel Beresniak.

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Russell, A., Beresniak, A., Bessette, L. et al. Cost-effectiveness modeling of abatacept versus other biologic agents in DMARDS and anti-TNF inadequate responders for the management of moderate to severe rheumatoid arthritis. Clin Rheumatol 28, 403–412 (2009). https://doi.org/10.1007/s10067-008-1060-4

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  • DOI: https://doi.org/10.1007/s10067-008-1060-4

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