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Rheumatoid Arthritis Therapy Options, Costs Analyzed Publish date: Nov 6, 2009  FRIDAY, Nov. 6 (HealthDay News) -- Treatment of early rheumatoid arthritis with disease-modifying antirheumatic drugs (DMARDs)
is more cost-effective than the pyramid therapy, but, for now, biologics should be reserved for disease of longer duration
or that is unresponsive to other treatment, according to a study in the Nov. 3 Annals of Internal Medicine. Axel Finckh, M.D., of the University of Geneva in Switzerland, and colleagues analyzed data from the National Data Bank
for Rheumatic Diseases and actual 2007 hospital costs. The researchers calculated the cost per quality-adjusted life-year
(QALY) for each of three management strategies: 1) the pyramid strategy beginning with initial nonsteroidal anti-inflammatory
drugs, patient education, pain management, and low-dose glucocorticoids, and adding DMARDs at one year for patients who do
not respond, 2) early DMARD therapy with methotrexate, and 3) early treatment with biologics (tumor necrosis factor inhibitors)
and methotrexate. The researchers found that the early DMARD and biologic strategies both reduced joint damage and increased quality-adjusted
life better than the pyramid strategy. For early DMARDs, when the cost of very early intervention was factored in, the cost-effectiveness
ratio was $4,849 per QALY compared to the pyramid strategy. However, the benefits gained with early treatment with biologics
cost $727,894 per QALY. The authors note that the early biologic strategy could become more cost-effective if the drugs
come down in price. "According to the most objective measures of rheumatoid arthritis progression, very early intervention with conventional
DMARDs is cost-effective. The cost-effectiveness of very early intervention with biologics remains uncertain," Finckh and
colleagues conclude. Several study authors reported receiving honoraria or having consulting arrangements or pending grant applications with
several pharmaceutical companies. Abstract Copyright © 2009 ScoutNews, LLC. All rights reserved. |   Practice Tools Coding Counselor Simple and accurate ICD-9 code search. Start Here  Formulary Counselor Find health plan drug coverage in your area. Start Here  Patient Education Print customized patient education handouts. Start Here  Surgical Video Center On-demand surgery demos and presentations. Start Here    
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