RESEARCH - Orencia cost-effective for treatment of RA

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Abatacept Cost-Effective for Treatment Rheumatoid Arthritis

By Martha Kerr

NEW YORK (Reuters Health) Oct 14 - The selective costimulation

modulator abatacept is cost-effective in the treatment of patients

with moderate-to-severe rheumatoid arthritis (RA), investigators

report in the Journal of Rheumatology.

Dr. Gerry Oster of Policy Analysts, Inc., of Brookline, Massachusetts,

and colleagues developed a simulation model to depict progression of

disability in a hypothetical cohort of 1,000 women aged 55-64 years

with moderately to severely active RA and inadequate response to tumor

necrosis factor alpha-antagonists.

At baseline, patients were assumed to receive either oral disease

modifying antirheumatic drugs (DMARDs) only or oral DMARDs plus

abatacept. Patients were then tracked from model entry until death.

Cost-effectiveness was expressed in terms of incremental cost, in 2006

US dollars, per quality-adjusted life year (QALY) gained over 10 years

and over a lifetime.

Abatacept would yield 1.0 additional QALY per patient over ten years,

with 4.0 QALY for abatacept compared with 3.0 QALY for oral DMARDs

alone. Over a lifetime, the additional QALY gained was 1.6.

Cost-effectiveness was $50,576 per QALY gained over 10 years, and

$45,979 per QALY gained over a lifetime, Dr. Oster and colleagues

report in the September issue of the Journal.

" Abatacept is cost-effective by current standards of medical practice

in patients with moderately to severely active RA and inadequate

response to an anti-TNF, " the investigators conclude.

" I don't believe that (abatacept) is more cost-effective than other

biologic response modifiers, " Dr. Oster told Reuters Health. " A

particular drug works for one person, but not another, and vice versa.

So, rheumatologists like to have lots of 'bullets in their gun,' that

is, drugs from which to choose. "

" The question is whether any new medication -- in this instance,

abatacept -- provides value for money relative to other treatments

widely used in the patient population of interest. Our study answers

that question in the affirmative with respect to abatacept. "

J Rheum 2008;35:1745-1753.

http://www.medscape.com/viewarticle/582046

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