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Cost Effectiveness of Therapeutic Interventions in Ankylosing Spondylitis: A Critical and Systematic Review

  • Ccile Gaujoux-Viala

    (Universit Pierre et Marie Curie (UPMC) Paris VI, GRC-UMPC 08 (EEMOIS), Paris, France; Department of Rheumatology, AP-HP, Piti� Salp�tri�re Hospital, Paris, France; EA 4360 Apemac, Lorraine University, Paris Descartes University, Nancy, France)

  • Bruno Fautrel

    (Universit Pierre et Marie Curie (UPMC) Paris VI, GRC-UMPC 08 (EEMOIS), Paris, France; Department of Rheumatology, AP-HP, Piti� Salp�tri�re Hospital, Paris, France)

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    Objectives:Objectives: This report reviews the cost effectiveness of different therapeutic interventions used in the treatment of ankylosing spondylitis (AS). Abstract: Methods:Methods: We performed a systematic search of the databases MEDLINE via PubMed, EMBASE and the Cochrane Library and used hand-searching to identify articles on cost effectiveness of therapies for adult patients with AS published up to November 2010. Abstract: Results:Results: Of 135 articles, 13 studies were analysed. Two articles were on physical therapies, one article was on NSAIDs and ten articles were on tumour necrosis factor (TNF) inhibitors (infliximab - 6, etanercept - 2, infliximab and etanercept - 1 and adalimumab - 1). Of the latter, no article directly compared TNF inhibitors. Articles showed substantial heterogeneity in methodological approaches and thus results, which prevented us from any extensive comparison, data pooling or meta-analysis. The incremental cost-effectiveness ratio (ICER) for spa-exercise treatment was &U20AC;7465 (95% CI 3294, 14 686) per QALY. The ICERs for infliximab, etanercept and adalimumab were &U20AC;5307-237 010, &U20AC;29 815-123 761 and &U20AC;7344-33 303 per QALY, respectively. Abstract: Conclusions:Conclusions: Modelling treatment strategies in chronic relapsing diseases such as AS presents specific challenges, as reflected in the variation in the cost-effectiveness results reported. Although quite variable, the cost-effectiveness ratios for AS therapies remain within an acceptable range.

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

    Volume (Year): 30 (2012)
    Issue (Month): 12 ()
    Pages: 1145-1156

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    Handle: RePEc:wkh:phecon:v:30:y:2012:i:12:p:1145-1156
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