Impact of etanercept on the costs of rheumatoid arthritis (RA): results from a French observational study

Joint Bone Spine. 2008 Jan;75(1):25-8. doi: 10.1016/j.jbspin.2007.04.013. Epub 2007 Aug 27.

Abstract

Introduction: Economical impact of rheumatoid arthritis (RA) has been widely modified thanks to TNF inhibitors. Our study aims to estimate the impact etanercept prescription, in term of health resources consumption, within a regional cohort of French RA patients.

Methods: The study included 148 RA patients, with a mean follow-up duration of 343 days before and after etanercept initiation. Data were anonymously collected from ERASME database of French Health Insurance in Midi-Pyrénées region. A patient-by-patient microcosting approach was performed.

Results: The average annual cost per patient, attributable to RA, was 2.8 times higher after treatment by etanercept than before (15,148.57euro versus 5248.95euro). We observed a rise in pharmaceutical costs, from 11.7% of direct medical costs before to 69.7% after etanercept initiation (120.12euro versus 9995.23euro). We observed a small decrease particularly for NSAIDs (142.14euro versus 102.21euro) and physiotherapy (286.40euro versus 138.77euro). Attributable act costs and indirect costs did not differ before and after etanercept initiation.

Discussion: In this short-term study, initiation of etanercept in RA patients did not come along with a decrease of consumption of health resources. Long-term studies are needed to reveal a potential economical advantage as a consequence of the clinical, structural and functional efficacy of anti-TNF.

MeSH terms

  • Adult
  • Antirheumatic Agents / economics*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / economics*
  • Arthritis, Rheumatoid / rehabilitation
  • Cost of Illness
  • Costs and Cost Analysis
  • Etanercept
  • Female
  • France
  • Health Resources / statistics & numerical data
  • Humans
  • Immunoglobulin G / economics*
  • Immunoglobulin G / therapeutic use
  • Male
  • Middle Aged
  • Physical Therapy Modalities / economics
  • Physical Therapy Modalities / statistics & numerical data
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Etanercept