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A Cost-Cost Study Comparing Etanercept with Infliximab in Rheumatoid Arthritis

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Author Info

  • Mark J.C. Nuijten

    (MEDTAP International, Amsterdam, The Netherlands)

  • Peter Engelfriet

    (MEDTAP International, Amsterdam, The Netherlands)

  • Klaas Duijn

    (Wyeth, Hoofddorp, The Netherlands)

  • George Bruijn

    (Medisch Centrum Leeuwarden, The Netherlands)

  • David Wierz

    (Wyeth-Ayerst, Raonor, Pennsylvania, USA)

  • Marc Koopmanschap

    (Institute for Medical Technology, Erasmus University, Rotterdam, The Netherlands)

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    Abstract

    Objective: The objective of this study was to compare the total costs associated with the administration of two different tumour necrosis factor (TNF) strategies used in the treatment of rheumatoid arthritis (RA): etanercept, a soluble TNF receptor that can be administered at home by subcutaneous injection, versus infliximab, an antibody that requires an intravenous infusion in a hospital outpatient setting. Design and setting: The main analytical framework of the study was a cost-cost analysis comparing the total annual costs associated with the administration of etanercept and infliximab in adult RA patients. The perspective of the study was that of the Dutch society. An economic model was constructed to determine the costs of both treatments. The cost evaluation included direct medical costs, direct nonmedical costs and indirect costs. The base-case analysis compared monotherapy with etanercept versus a combination therapy with infliximab and methotrexate. Data for the economic model came from published literature, expert opinion and official price and tariff lists. All costs were in 1999 values. Patients and participants: The analysis was performed for the adult RA population eligible for treatment with etanercept or infliximab in The Netherlands. Main outcome measures and results: The analysis showed that the total annual drug costs per patient do not differ substantially between infliximab and etanercept, with costs of Netherland guilders (NLG)31 526 ($US12 610) and NLG31 334 ($US12 534), respectively. However, the other medical costs (i.e. excluding the costs of the two drugs themselves) are substantially higher for infliximab due to the additional costs associated with administration in an outpatient clinic and the use of methotrexate [NLG12 621 ($US5048) versus NLG269 ($US107) for etanercept]. The impact of direct nonmedical costs (transportation) and indirect costs were negligible. Overall treatment with infliximab is more expensive than treatment with etanercept with total costs of NLG45 115 ($US18 046) and NLG31 621 ($US12 648), respectively (42.7% increase). Conclusions: Based on the assumptions used in the model, we may conclude that the use of etanercept compares favourably with infliximab from a budgetary and health economic perspective: the total costs are substantially lower when the efficacy of etanercept is assumed to be at least equivalent to the efficacy of infliximab.

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 19 (2001)
    Issue (Month): 10 ()
    Pages: 1051-1064
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:19:y:2001:i:10:p:1051-1064

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    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Anti TNF monoclonal antibodies; Antirheumatics; Cost analysis; Etanercept; Infliximab; Pharmacoeconomics; Rheumatoid arthritis; Tumour necrosis factor antagonists;

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