COST-EFFECTIVENESS ANALYSIS OF DRUG THERAPIES FOR RHEUMATOID-ARTHRITIS

We know very little about the relative cost effectiveness of commonly used drug treatments for rheumatoid arthritis (RA), largely due to dif ficulty obtaining appropriate data and the complexity of the required analysis. There is growing interest in combination therapy for RA. How ever, it is unclear whether combination therapy will be associated wit h increased benefit compared to monotherapy, and whether the degree of benefit will offset the anticipated increased costs. We show 3 specif ic examples derived from a longitudinal database of adults with RA in which we compare the cost effectiveness of longterm drug regimens, Fun ctional status serves as our measure of effectiveness, and we use a co nservative estimate of the total annual cost of drug therapy. We also consider the analytic complexity of differences in baseline disease ac tivity. These examples illustrate that in addition to variability in b aseline disease activity, there is also substantial variability over t ime in both effectiveness and costs associated with drug treatment. Th is variability underscores the importance of considering both the rela tive effectiveness and costs when making treatment decisions. To make progress in the area of cost effectiveness of longterm treatments for RA and other chronic conditions, it is essential that studies of treat ment continue for sufficiently long periods and that relevant cost inf ormation be collected in conjunction with measures of effectiveness.