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Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment
 
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Submission date: 2018-04-26
 
 
Final revision date: 2018-10-29
 
 
Acceptance date: 2018-11-17
 
 
Online publication date: 2018-12-23
 
 
Publication date: 2018-12-23
 
 
Reumatologia 2018;56(6):340-345
 
KEYWORDS
TOPICS
ABSTRACT
Objectives:
Among autoimmune diseases, rheumatoid arthritis (RA) is the most common chronic inflammatory disease of the joints. Its pathogenesis is still not fully understood, but the gained knowledge has contributed to the development of modern treatment. The introduction of biological therapy for RA has been a breakthrough in the standard approach to the treatment of this disease.

Material and methods:
The study material was retrospectively collected in the Rheumatology and Systemic Tissue Diseases Clinic and Rheumatology Outpatient Clinic in dr. Jan Biziel University Hospital No. 2 in Bydgoszcz. Patients were divided into 3 groups: patients receiving infliximab – 43 patients, etanercept – 27 patients and adalimumab – 34 patients. In the study, the pharmacoeconomic analysis included direct and indirect medical costs. Direct medical costs analyzed in the study included costs for the purchase of medications, diagnostic and imaging costs, and medical consultations and hospitalization costs. The analysis included all direct medical costs incurred by the hospital and the patient, as well as indirect costs outside the healthcare sector – that is, the Polish Social Insurance Institution benefits (disability benefits, rehabilitation benefits, sickness absences). Direct medical costs are also presented from the perspective of the payer – The Polish National Health Fund – taking into account the cost and percentage share of medical expenses.

Results:
The analysis concerned resources used since the beginning of treatment with a given biological medication for 24 months or earlier if disease remission occurred. A cost-benefit analysis was carried out in the study using biosimilar medications present on the market in relation to the treatment regimens. Considering the total cost, if only Inflectra were used in therapy, PLN 18 151.98 per patient could be saved, and in the case of Remsima, PLN 16 385.14. In less than 19 months, to use infliximab for 43 patients, PLN 780 475.80 more would have to be spent than in the case of the biosimilar medication Inflectra, and PLN 704 561 in the case of Remsima. The highest total cost is generated by treatment with adalimumab, followed by etanercept, and infliximab. Of the costs analyzed, a significant majority was for biological treatment.

Conclusions:
Given the Polish financial conditions, the best solution now is to reduce the prices of biological medications. This is possible through the introduction of biosimilar medications that, when placed on the market, reduce the price of the original medication, as is currently the case with Remicade and Enbrel. The introduction of Inflectra and Remsima, as well as Benepali and Erelzi, has reduced the price base of original medications to similar levels of treatment with biosimilar medications. The wider use of biological treatment would also reduce indirect costs.

 
REFERENCES (16)
1.
Felson D, Anderson J, Boers M, et al. American College of Rheumatology preliminary definitions of improvement in rheumatoid arthritis. Arthritis Rheum 1995; 38: 727-735.
 
2.
Kobelt G, Kasteng F. Access to innovative treatments in rheumatoid arthritis in Europe. A report prepared for the European Federation Of Pharmaceutical Industry Associations (EFPIA). 2009: 1-92.
 
3.
Orlewska E, Wiland P. Access to biologic treatment for rheumatoid arthritis in Central and Eastern European (CEE) countries. Med Sci Monit 2011; 17: 1-13.
 
4.
Ruszkowski J, Leśniowska J, Gierczyński J, et al. Koszty pośrednie i bezpośrednie leczenia reumatoidalnego zapalenia stawów w Polsce. Farmakoekonomika 2009; 13: 3-9.
 
5.
Wałdysiuk M. Mulitmedial presentation: Koszty pośrednie w ocenie technologii medycznych. Metodyka i rekomendacje dla Polski (Indirect costs in medical technology assessment. Methodology and recommendations for Poland). XXIII Economic Forum, Krynica-Zdrój 2014.
 
6.
Głuszko P, Filipowicz-Sosnowska A, Tłustochowicz W. Reumatoidalne zapalenie stawów. Reumatologia 2012; 50: 83-90.
 
7.
Moreland LW, Schiff MH, Baumgartner SW, et al. Etanercept therapy in rheumatoid arthritis. A randomized, controlled trail. Ann Intern Med 1999; 130: 478-486.
 
8.
Stajszczyk M. Raport. Leczenie biologiczne w chorobach reumatycznych w Polsce w 2013 r. Polskie Towarzystwo Reumatologiczne, Warszawa 2013: 1-20.
 
9.
Koligat D, Paczkowska A, Leszczyński P, et al. Analiza kosztów farmakoterapii u pacjentów z reumatoidalnym zapaleniem stawów leczonych biologicznymi lekami modyfikującymi przebieg choroby. Now Lek 2013; 82: 394-398.
 
10.
Koligat D. Kalkulacja kosztów leczenia oraz ocena jakości życia pacjentów z reumatoidalnym zapaleniem stawów. Katedra i Zakład Farmakoekonomiki i Farmacji Społecznej Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu, Poznań 2014.
 
11.
Report on biological treatment. Porównajmy się z innymi krajami (Let’s compare ourselves with other countries): http://www.rynek zdrowia.pl/Serwis-Reumatologia/Raport-nt-leczenia-biologicznegoPorownajmy-sie-z-innymi-krajami,136600,1011.html (access from 26.04.2018).
 
12.
Kotarba-Kańczugowska M, Kucharski K, Linder-Kopiecka I, et al. JA PACJENT! Perspektywa Organizacji Pacjenckich na Stan Opieki Reumatologicznej w Polsce. Raport Organizacji Pacjenckich, Warszawa 2014: 115-118. http://zzsk.org.pl/documents/J... (access from 26.04.2018).
 
13.
Wróbel P. Chorzy mają głos. Rynek Zdrowia 2013; 9: 22-26.
 
14.
Bebrysz M, Fedyna M, Rutkowski J, et al. Przewlekłe choroby zapalne mediowane immunologicznie – ocena kosztów pośrednich w Polsce. Central and Eastern European Society of Technology Assessment in Health Care, Kraków 2014: 29-58.
 
15.
Bogusławski S. Reumatoidalne zapalenie stawów. Wydatki na leczenie RZS w Polsce. Sequence HC Partners Sp. z o.o., Warszawa 2015: 2-8.
 
16.
Zheltoukhova K, Bevan S, Reich A. Zdolni do pracy? Choroby układu mięśniowo-szkieletowego a rynek pracy w Polsce. The Work Foundation, London 2011: 1-116.
 
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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ISSN:0034-6233
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