FRI0070 Cost-effectiveness of biologic agents for rheumatoid arthritis was superior to traditional/conventional dmards when analysed with number needed to treat(NNT) method
Authors: K. Harigane, Y. Mochida, K. Sahara, N. Mitsugi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Recently biologic agents are widely used for patients with rheumatoid arthritis (RA). Biologic agents are reported to have higher effectiveness than other disease-modifying anti-rheumatic drugs (DMARDs) including methotrexate (MTX), however, those new agents are more expensive. <h3>Objectives</h3> This study evaluated the cost-effectiveness of biologic agents for RA using number needed to treat (NNT) method. NNT is an index for determining the number of patients who need to be treated in order to reach a patient toward to clinical goal when a new treatment is introduced. <h3>Methods</h3> Fifty-three patients with RA was included in this study. These patients were introduced biologic agents between September 2012 to ,<sup>March 2017</sup><sup>and</sup> continued same agent up to 24 weeks. NNT was calculated based on disease activity score (DAS28-ESR) and clinical disease activity index (CDAI) at 24 weeks. Ninety-four patients were investigated as a control group who treated with DMARDs. In addition, actual healthcare cost including doctor's fee, laboratory examination, prescription fee, and cost of biologic agents in each patient were calculated based on hospital's medical receipt, then averaged and compared between two groups. <h3>Results</h3> In biologic group, tocilizumab (TCZ) were used for 20 patients, golimmab (GLM) for 14 patients, etanercept (ETN) for 13 patients, and other biologics for six patients. In control group, 66 patients administered MTX and/or conventional DMARDs (csDMARDs), and 28 patients administered only csDMARDs. In biologic group, 53 patients (79.2%) achieved remission in DAS28-ESR, and 24 patients (45.2%) achieved remission in CDAI. On the other hand, the rate of remission was 61.7% and 23.4% respectively in control group. NNT was 1.26 (DAS28) and 2.21 (CDAI) in biologic group, and 1.62 and 4.27 respectively in control group. In biologic group, NNT based on DAS28-ESR of each agent was 1.11 of TCZ, 1.30 of ETN, 1.40 of GLM, and 1.50 of others (table 1). The total actual healthcare cost in the study period was 7,812.5 Euro (1044066 JPY; 1 Euro=133.6 JPY, in December 2017) in biologic group and 583.8 Euro (78020 JPY) in control group. <h3>Conclusions</h3> The total actual health care cost of biologic group was much higher than DMARDs group, however, the cost-effectiveness of biologics was superior to DMARDs from the stand point of NNT. <h3>Reference</h3> [1] Alberto B, et al. Efficacy and Treatment Costs of Monotherapy with bDMARDs in the Treatment of Rheumatoid Arthritis in Patients Intolerant to or Inappropriate to Continue Treatment with Methotrexate. Adv Ther2016;33:1360–73. <h3>Disclosure of Interest</h3> K. Harigane: None declared, Y. Mochida: None declared, K. Sahara Grant/research support from: Takeda Pharmaceutical Company Limited, Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Teijin Limited Chugai Pharmaceutical Co., Ltd, Astellas Pharma Inc., N. Mitsugi: None declared