Cost-Effectiveness of Biologics in Early Rheumatoid Arthritis
Authors: Axel Finckh
Journal: Annals of Internal Medicine (2010)

Letters2 March 2010Cost-Effectiveness of Biologics in Early Rheumatoid ArthritisAxel Finckh, MD, MS, Nick Bansback, MS, and Matthew H. Liang, MD, MPHAxel Finckh, MD, MSFrom Geneva University Hospital, 1205 Geneva, Switzerland; University of British Columbia, St. Paul's Hospital, Vancouver, V6Z 1Y6 British Columbia, Canada; and Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this author, Nick Bansback, MSFrom Geneva University Hospital, 1205 Geneva, Switzerland; University of British Columbia, St. Paul's Hospital, Vancouver, V6Z 1Y6 British Columbia, Canada; and Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this author, and Matthew H. Liang, MD, MPHFrom Geneva University Hospital, 1205 Geneva, Switzerland; University of British Columbia, St. Paul's Hospital, Vancouver, V6Z 1Y6 British Columbia, Canada; and Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-5-201003020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We appreciate Boers' (1) ideas about our cost-effectiveness study (2), but some require comment. He says, “Curiously, the investigators shy away from a firm conclusion, instead stating that the cost-effectiveness of early biologics is still uncertain.” We feel that the case cannot be closed for at least 3 major reasons.First, the long-term effects of very early initiation of aggressive antirheumatic therapy, and biologic therapy in particular, are largely unknown. These include long-term effects on mortality, the need for joint replacement, and the rate of disability decades after starting these therapeutic strategies.Second, other variables profoundly affect ...References1. Boers M. Cost-effectiveness of biologics as first-line treatment of rheumatoid arthritis: case closed? [Editorial]. Ann Intern Med. 2009;151:668-9. [PMID: 19884628] LinkGoogle Scholar2. Finckh A, Bansback N, Marra CA, Anis AH, Michaud K, Lubin S, et al. Treatment of very early rheumatoid arthritis with symptomatic therapy, disease-modifying antirheumatic drugs, or biologic agents: a cost-effectiveness analysis. Ann Intern Med. 2009;151:612-21. [PMID: 19884622] LinkGoogle Scholar3. Da Silva JA, Jacobs JW, Kirwan JR, Boers M, Saag KG, Inês LB, et al. Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data. Ann Rheum Dis. 2006;65:285-93. [PMID: 16107513] CrossrefMedlineGoogle Scholar4. Maillefert JF. Appropriate and inappropriate use of oral glucocorticoid therapy in rheumatoid arthritis [Editorial]. Joint Bone Spine. 2006;73:234-5. [PMID: 16563844] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Geneva University Hospital, 1205 Geneva, Switzerland; University of British Columbia, St. Paul's Hospital, Vancouver, V6Z 1Y6 British Columbia, Canada; and Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Biologics as First-Line Treatment of Rheumatoid Arthritis: Case Closed? Maarten Boers Treatment of Very Early Rheumatoid Arthritis With Symptomatic Therapy, Disease-Modifying Antirheumatic Drugs, or Biologic Agents Axel Finckh , Nick Bansback , Carlo A. Marra , Aslam H. Anis , Kaleb Michaud , Stanley Lubin , Marc White , Sonia Sizto , and Matthew H. Liang Cost-Effectiveness of Biologics in Early Rheumatoid Arthritis Maarten Boers Metrics Cited ByEvolution of Direct Costs in the First Years of Rheumatoid Arthritis: Impact of Early versus Late Biologic Initiation - An Economic Analysis Based on the ESPOIR CohortChoosing wisely: The American College of Rheumatology's top 5 list of things physicians and patients should questionTreatment strategies aiming at remission in early rheumatoid arthritis patients: starting with methotrexate monotherapy is cost-effectiveNovel approaches to incorporating pharmacoeconomic studies into phase III clinical trials for Alzheimer's disease 2 March 2010Volume 152, Issue 5Page: 333-334KeywordsDrugsHypertensionObesityOsteoporosisPopulation statisticsRheumatoid arthritisSteroids ePublished: 2 March 2010 Issue Published: 2 March 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...