Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study
Abstract Background The study aimed to examine the direct medical cost and impact of tocilizumab (TOZ) versus adalimumab (ADM) and etanercept (ETC) on reducing the levels of two inflammatory markers (e.g., C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) among patients with rheumat...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Cost Effectiveness and Resource Allocation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12962-024-00522-7 |
| _version_ | 1827327340493930496 |
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| author | Areej S. Albahdal Amjad M. Alotaibi Miteb A. Alanazi Norah Abanmy Monira Alwhaibi Yazed AlRuthia |
| author_facet | Areej S. Albahdal Amjad M. Alotaibi Miteb A. Alanazi Norah Abanmy Monira Alwhaibi Yazed AlRuthia |
| author_sort | Areej S. Albahdal |
| collection | DOAJ |
| description | Abstract Background The study aimed to examine the direct medical cost and impact of tocilizumab (TOZ) versus adalimumab (ADM) and etanercept (ETC) on reducing the levels of two inflammatory markers (e.g., C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) among patients with rheumatoid arthritis (RA) using real-world data from Saudi Arabia. Method This was a single-center retrospective cohort study in which data for biologic-naïve RA patients aged ≥ 18 years and treated with TOZ, ADM, ETC were retrieved from the electronic medical records (EMRs) of a university-affiliated tertiary care center in Riyadh, Saudi Arabia. Patients were followed up at least one year after the treatment initiation. Bottom-up microcosting was utilized to estimate the direct medical costs. Additionally, inverse probability treatment weighting and bootstrapping with 10,000 replications were conducted to generate 95% confidence levels for costs and the mean reductions in CRP and ESR levels. Results The number of patients who met the inclusion criteria and were included in the analysis was 150 patients (TOZ (n = 56), ADM (n = 41), ETC (n = 53)). Patients on TOZ had 3.96 mg/L (95% CI: -0.229–4.95) and 11.21 mm/hr (95% CI: 10.28–18.11) higher mean reductions in the CRP and ESR levels compared to their counterparts on ADM, ETC, respectively. However, this was associated with mean annual incremental costs of USD 10,087.88 (95% CI: 9494.50–11,441.63) in all cost-effectiveness bootstrap distributions. Conclusion Tocilizumab has shown better effectiveness in reducing the levels of CRP and ESR but with higher costs. Future studies should examine whether the reduction of these two inflammatory markers is associated with quality-adjusted life years (QALYs) gains. |
| first_indexed | 2024-03-07T14:58:47Z |
| format | Article |
| id | doaj.art-c18466bafb4b4e77b3c39bbbd050098f |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-03-07T14:58:47Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-c18466bafb4b4e77b3c39bbbd050098f2024-03-05T19:15:47ZengBMCCost Effectiveness and Resource Allocation1478-75472024-02-0122111010.1186/s12962-024-00522-7Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center studyAreej S. Albahdal0Amjad M. Alotaibi1Miteb A. Alanazi2Norah Abanmy3Monira Alwhaibi4Yazed AlRuthia5Department of Clinical Pharmacy, College of Pharmacy, King Saud UniversityDepartment of Clinical Pharmacy, College of Pharmacy, King Saud UniversityDepartment of Pharmacy, King Khalid University HospitalDepartment of Clinical Pharmacy, College of Pharmacy, King Saud UniversityDepartment of Clinical Pharmacy, College of Pharmacy, King Saud UniversityDepartment of Clinical Pharmacy, College of Pharmacy, King Saud UniversityAbstract Background The study aimed to examine the direct medical cost and impact of tocilizumab (TOZ) versus adalimumab (ADM) and etanercept (ETC) on reducing the levels of two inflammatory markers (e.g., C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) among patients with rheumatoid arthritis (RA) using real-world data from Saudi Arabia. Method This was a single-center retrospective cohort study in which data for biologic-naïve RA patients aged ≥ 18 years and treated with TOZ, ADM, ETC were retrieved from the electronic medical records (EMRs) of a university-affiliated tertiary care center in Riyadh, Saudi Arabia. Patients were followed up at least one year after the treatment initiation. Bottom-up microcosting was utilized to estimate the direct medical costs. Additionally, inverse probability treatment weighting and bootstrapping with 10,000 replications were conducted to generate 95% confidence levels for costs and the mean reductions in CRP and ESR levels. Results The number of patients who met the inclusion criteria and were included in the analysis was 150 patients (TOZ (n = 56), ADM (n = 41), ETC (n = 53)). Patients on TOZ had 3.96 mg/L (95% CI: -0.229–4.95) and 11.21 mm/hr (95% CI: 10.28–18.11) higher mean reductions in the CRP and ESR levels compared to their counterparts on ADM, ETC, respectively. However, this was associated with mean annual incremental costs of USD 10,087.88 (95% CI: 9494.50–11,441.63) in all cost-effectiveness bootstrap distributions. Conclusion Tocilizumab has shown better effectiveness in reducing the levels of CRP and ESR but with higher costs. Future studies should examine whether the reduction of these two inflammatory markers is associated with quality-adjusted life years (QALYs) gains.https://doi.org/10.1186/s12962-024-00522-7TocilizumabEtanerceptAdalimumabArthritisRheumatoidCost analysis |
| spellingShingle | Areej S. Albahdal Amjad M. Alotaibi Miteb A. Alanazi Norah Abanmy Monira Alwhaibi Yazed AlRuthia Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study Cost Effectiveness and Resource Allocation Tocilizumab Etanercept Adalimumab Arthritis Rheumatoid Cost analysis |
| title | Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study |
| title_full | Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study |
| title_fullStr | Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study |
| title_full_unstemmed | Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study |
| title_short | Cost-consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in Saudi Arabia: a single-center study |
| title_sort | cost consequence analysis of tocilizumab versus adalimumab and etanercept among rheumatoid arthritis patients in saudi arabia a single center study |
| topic | Tocilizumab Etanercept Adalimumab Arthritis Rheumatoid Cost analysis |
| url | https://doi.org/10.1186/s12962-024-00522-7 |
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