COST-EFFECTIVENESS OF TREATMENT OF RHEUMATOID ARTHRITIS WITH BIOLOGICAL DRUGS IN GEORGIA.

Abstract

Aim: This study aims to assess the cost-effectiveness of treatment with biological drugs-specifically infliximab, adalimumab, and rituximab-both as monotherapy and in combination therapy for patients with rheumatoid arthritis. Additionally, we will identify the factors that influence this process.

Materials and methods: A total of 60 patients with moderate to severe rheumatoid arthritis (DAS28 > 3.2) were selected for the study. The participants were divided into three groups and two subgroups based on the specific group of drugs they received. The study was conducted for 12 months. Before and after treatment, health status was assessed with baseline questionnaires (HAQ). Cost-effectiveness assessment of the five-dimensional health status classification methodology using EQ-5D and multiple regression related HAQ score system and disease activity. Patients were also assessed with the general SF-36 health status questionnaire.

Results and discussion: This study provides important clinical insights as it is a study that directly compares three different biological treatment options for patients with rheumatoid arthritis who have failed standard therapy. All treatment options had a good safety profile. A cost-effectiveness analysis of QALYs found that rituximab was the most effective treatment in patients with severe rheumatoid arthritis who had failed TNF-α inhibitor treatment. In our analysis, drug-related costs depended on drug price, dose, route of administration, and dosing frequency.

Conclusions: According to the results of this study, infliximab was more cost-effective than adalimumab. Therefore, based on the results of the sensitivity analysis, as long as the study parameters do not change significantly, it is suggested that infliximab should be the priority for the treatment of patients with rheumatoid arthritis. And rituximab is the most effective treatment option for patients who have failed TNF-α treatment. This advantage is primarily due to differences in drug costs; because efficacy and safety are the same, drug costs may drive decisions about biological treatment.