Analysis and evaluation of the cost of the treatment anti-TNFalfa in rheumatoid arthritis and ankylosing spondylitis. Individualised front marketed dose.
DOI:
https://doi.org/10.19230/jonnpr.1179Keywords:
Adalimumab, etanercept, infliximab, anti-TNFAbstract
Objective: to assess the cost of different biological therapies through the analysis of the theoretical and actual annual costs in routine clinical practice.
Materials and method: retrospective observational study in patients with rheumatoid arthritis (RA) or spondylitis (AS) who initiated treatment with any of the available anti-TNF-alfa may of 2013 to September 2015. The average annual cost per patient depending on the treatment and pathology analyzed.
Results: 94 pharmaceutical records of patients with rheumatologic disease diagnosed were analyzed [49 (52.1%)] AR and 45 (47.9%) EA]. Treatment received during the period of study: patients with RA (49.0% adalimumab, 44.9% etanercept, 6.1% infliximab); patients with AD (44.4% adalimumab, 37.8% etanercept, 17.8% infliximab). The average annual cost per patient was €12.009,3. There were no differences in annual costs among the different treatments for RA [(11.977,8 € adalimumab, 11.015,2 € etanercept, 10.717,8 € infliximab; p>0,05), while in the case of the EA etanercept turned out to be the lowest cost treatment [(12.231,49 € adalimumab, 12.088,2 € etanercept, 14.598,7 € infliximab; p<0.05).]]
Conclusions: the choice of etanercept appears to contribute to lower pharmaceutical spending in our environment. Would be necessary an optimization in the management of our patients to achieve a better adjustment of doses that allowed optimize the expenditure pharmaceutical
Downloads
References
Gonzalez-Alvaro I, Martinez-Fernandez C, Dorantes-Calderon B, Garcia-Vicuna R, Hernandez-Cruz B, Herrero-Ambrosio A et al. Spanish Rheumatology Society and Hospital Pharmacy Society Consensus on recommendations for biologics optimization in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Rheumatology (Oxford) 2015;54(7):1200-1209.
Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet 2001;358(9285):903-911.
Dougados M, Baeten D. Spondyloarthritis. Lancet 2011;377(9783):2127-2137.
Carmona L, Gonzalez-Alvaro I, Balsa A, Angel BM, Tena X, Sanmarti R. Rheumatoid arthritis in Spain: occurrence of extra-articular manifestations and estimates of disease severity. Ann Rheum Dis 2003;62(9):897-900.
Braun J, Pincus T. Mortality, course of disease and prognosis of patients with ankylosing spondylitis. Clin Exp Rheumatol 2002;20(6 Suppl 28):S16-S22.
Fernández Pérez A, Pérez Rodríguez N, Piñeiro Conde S, I López Rodríguez I, López García V. Terapias biológicas en artritis reumatoide: Análisis del coste de las alternativas terapéuticas. Galicia Clin 2012;73((4)):143-146.
Furst DE, Keystone EC, So AK, Braun J, Breedveld FC, Burmester GR et al. Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2012. Ann Rheum Dis 2013;72 Suppl 2:ii2-34.
Machado MA, Barbosa MM, Almeida AM, de Araujo VE, Kakehasi AM, Andrade EI et al. Treatment of ankylosing spondylitis with TNF blockers: a meta-analysis. Rheumatol Int 2013;33(9):2199-2213.
den BA, van de Putte L, Rau R, Schattenkirchner M, Van RP, Sander O et al. A single dose, placebo controlled study of the fully human anti- tumor necrosis factor-alpha antibody adalimumab (D2E7) in patients with rheumatoid arthritis. J Rheumatol 2002;29(11):2288-2298.
Korth-Bradley JM, Rubin AS, Hanna RK, Simcoe DK, Lebsack ME. The pharmacokinetics of etanercept in healthy volunteers. Ann Pharmacother 2000;34(2):161-164.
Borras-Blasco J, Navarro RA. Dose modification of anti-TNF in rheumatoid arthritis and estimated economical impact: a review of observational studies. Expert Rev Pharmacoecon Outcomes Res 2015;15(1):71-79.
Aaltonen KJ, Virkki LM, Malmivaara A, Konttinen YT, Nordstrom DC, Blom M. Systematic review and metaanalysis of the efficacy and safety of existing TNF blocking agents in treatment of rheumatoid arthritis. PLoS One 2012;7(1):e30275.
Rubio-Terres C, Ordovas Baines JP, Pla PR, Martinez NC, Sanchez Garre MJ, Rosado Souviron MA et al. [Use and cost of biological disease-modifying anti-rheumatic drugs in Spain (PRAXIS study)]. Farm Hosp 2007;31(2):78-92.
Gómez Gómez D, Colón López de Dicastillo A, Ochagavía Sufrategui M, Valero Domínguez M. Estimación del coste real de las terapias anti- TNF en enfermedades reumáticas. Revista de la O F I L 2014;25;2:91-100.
Borras-Blasco J, Castera MD, Cortes X, Rosique-Robles JD, Abad FJ. Economical impact associated with a biological therapy prioritization protocol in patients with rheumatoid arthritis in the Hospital of Sagunto. Expert Opin Biol Ther 2014;14(11):1561-1567.
Ramirez-Herraiz E, Escudero-Vilaplana V, Alanon-Plaza E, Trovato-Lopez N, Herranz-Alonso A, Morell-Baladron A et al. Efficiency of adalimumab, etanercept and infliximab in rheumatoid arthritis patients: dosing patterns and effectiveness in daily clinical practice. Clin Exp Rheumatol 2013;31(4):559-565.
Escudero-Vilaplana V, Ramirez-Herraiz E, Alanon-Plaza E, Trovato-Lopez N, Garcia-Vicuna R, Carreno-Perez L et al. Efficiency of adalimumab, etanercept and infliximab in ankylosing spondylitis in clinical practice. Int J Clin Pharm 2015;37(5):808-814.
Medicamentos anti-tnf: aspectos prácticos en atención primaria. Disponible en: http://www.osakidetza.euskadi.eus/contenidos/informacion/cevime_infac/eu_miez/adjuntos/infac_v17_n3.pdf [consultado el 17/11/2016].
Kleinberg M, Wilkinson K. Current and future considerations for the new classes of biologicals. Am J Health-Syst Pharm. 2004;61:695-710.
Jackson JM. TNF-a inhibitors. Dermatol Ther. 2007;20:251-64.
González D., Rodríguez, A.B., Pariente, J.A. "TNFa-induced apoptosis in human myeloid cell lines HL-60 and K562 is dependent of intracellular ROS generation". Molec and Cell Biochem 390: 281-287.
Additional Files
Published
Issue
Section
License
All accepted originals remain the property of JONNPR. In the event of publication, the authors exclusively transfer their rights of reproduction, distribution, translation and public communication (by any sound, audiovisual or electronic medium or format) of their work. To do so, the authors shall sign a letter transferring these rights when sending the paper via the online manuscript management system.
The articles published in the journal are freely used under the terms of the Creative Commons BY NC SA license, therefore.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License