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Sökning: onr:"swepub:oai:swepub.ki.se:508054" > Disease activity-gu...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00003423naa a2200349 4500
001oai:swepub.ki.se:508054
003SwePub
008260106s2016 | |||||||||||000 ||eng|
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1344824962 URI
0247 a https://doi.org/10.1136/annrheumdis-2015-2083172 DOI
040 a (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Kievit, W4 aut
2451 0a Disease activity-guided dose optimisation of adalimumab and etanercept is a cost-effective strategy compared with non-tapering tight control rheumatoid arthritis care: analyses of the DRESS study
264 c 2016-01-13
264 1b BMJ,c 2016
520 a A disease activity-guided dose optimisation strategy of adalimumab or etanercept (TNFi (tumour necrosis factor inhibitors)) has shown to be non-inferior in maintaining disease control in patients with rheumatoid arthritis (RA) compared with usual care. However, the cost-effectiveness of this strategy is still unknown.MethodThis is a preplanned cost-effectiveness analysis of the Dose REduction Strategy of Subcutaneous TNF inhibitors (DRESS) study, a randomised controlled, open-label, non-inferiority trial performed in two Dutch rheumatology outpatient clinics. Patients with low disease activity using TNF inhibitors were included. Total healthcare costs were measured and quality adjusted life years (QALY) were based on EQ5D utility scores. Decremental cost-effectiveness analyses were performed using bootstrap analyses; incremental net monetary benefit (iNMB) was used to express cost-effectiveness.Results180 patients were included, and 121 were allocated to the dose optimisation strategy and 59 to control. The dose optimisation strategy resulted in a mean cost saving of −€12 280 (95 percentile −€10 502; −€14 104) per patient per 18 months. There is an 84% chance that the dose optimisation strategy results in a QALY loss with a mean QALY loss of −0.02 (−0.07 to 0.02). The decremental cost-effectiveness ratio (DCER) was €390 493 (€5 085 184; dominant) of savings per QALY lost. The mean iNMB was €10 467 (€6553–€14 037). Sensitivity analyses using 30% and 50% lower prices for TNFi remained cost-effective.ConclusionsDisease activity-guided dose optimisation of TNFi results in considerable cost savings while no relevant loss of quality of life was observed. When the minimal QALY loss is compensated with the upper limit of what society is willing to pay or accept in the Netherlands, the net savings are still high.Trial registration numberNTR3216; Post-results.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi0 (SwePub)302252 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology0 (SwePub)302252 hsv//eng
7001 a van, Herwaarden N4 aut
7001 a van, den Hoogen FHJ4 aut
7001 a van, Vollenhoven RF4 aut
7001 a Bijlsma, JWJ4 aut
7001 a van, den Bemt BJF4 aut
7001 a van, der Maas A4 aut
7001 a den, Broeder AA4 aut
7730 t ANNALS OF THE RHEUMATIC DISEASESd : BMJg 75:11, s. 1939-1944q 75:11<1939-1944x 0003-4967x 1468-2060
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:134482496
8564 8u https://doi.org/10.1136/annrheumdis-2015-208317

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