#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Assessment of utility score EQ-D and estimating the Cost-utility of the first year of treatment by TNF inhibitors in a cohort of patients with Rheumatoid Arthritis during– results from the Czech biologics registry ATTRA


Authors: J. Závada 1;  M. Uher 2;  J. Jarkovský 2 ;  J. Vencovský 1,3;  K. Pavelka 1,3;  Kolektiv Lékařů Center Biologické Léčby
Authors place of work: Revmatologický ústav, Praha 1;  Institut biostatistiky a analýz, Masarykova univerzita, Brno 2;  Česká revmatologická společnost JEP 3
Published in the journal: Čes. Revmatol., 22, 2014, No. 1, p. 10-16.
Category: Original Papers

Summary

Introduction:
Utility scores are used as an input parameter for Quality Adjusted Life Years (QALYs) calculations in cost-utility analyses. Our aim was to evaluate the changes in utility score assessed by the EuroQOL-5D (EQ-5D) instrument during one year of the first-line treatment with TNF inhibitors (Etanercept, Adalimumab, Infliximab) in patients with rheumatoid arthritis (RA).

Patients and methods:
823 RA patients with available clinical data (DAS28, HAQ), and health-related quality of life (HRQOL) data (EQ-5D) completing one year treatment were included in the analysis.

Results:
In the analyzed sample there were 82 % females, median age was 51 years (IQR 41–58) and median disease duration of 7 years (IQR 3–13) at the beginning of anti-TNF therapy. 28 % were treated by infliximab, 46 % by adalimumab, and 26 % by etanercept. Patients’ QoL improved during the treatment—utility increased from a median of 0.16 to 0.69, and clinically meaningful improvements in EQ-5D were observed in 61 % of patients.

Conclusion:
Most patients with RA experienced clinically important improvements in HRQOL during the first year of treatment by TNF inhibitors. For this patient group, cost-utility ratios were within the recommended limits acceptable for payers of health care.

Key words:
Health-related quality of life, biologic disease-modifying anti-rheumatic drugs, anti-tumour necrosis factor drugs, rheumatoid arthritis, registry, EQ-5D


Zdroje

1. Dadoun S, Zeboulon-Ktorza N, Combescure C, Elhai M, Rozenberg S, Gossec L, Fautrel B. Mortality in rheumatoid arthritis over the last fifty years: Systematic review and meta-analysis. Joint Bone Spine. 2012 Mar 27. 

2. Yelin E, Callahan LF. The economic cost and social and psychological impact of musculoskeletal conditions. The National Arthritis Data Work Groups. Arthritis Rheum 1995; 38 (10): 1351–62

3. Torrance GW. Measurement of health state utilities for economic appraisal: A review. J Health Econ 1986, 5:1–30.

4. The €oQol Group: €oQol–a new facility for the measurement of health-related quality of life. The €oQol Group. Health Policy 1990, 16:199–208.

5. Dolan P, Gudex C, Kind P, et al. The time trade-off method: results from a general population study. Health Econ 1996; 5 (2): 141–54.

6. Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res 2005;14:1523–32.

7. Závada J, Uher M, Hejduk K, Vencovský J, Pavelka K a kolektiv lékařů biologických center. Zdravím podmíněná kvalita života u pacientů s revmatoidní artritidou v průběhu prvního roku anti-TNF léčby – výsledky z registru biologické léčby ATTRA. Čes Revmatol 2013; 21(3): 123–133.

8. Harrison MJ, Davies LM, Bansback NJ, et al. Why do patients with inflammatory arthritis often score states ‘worse than death’ on the EQ-5D? An investigation of the EQ- 5D classification system. Value Health 2009 Sep; 12 (6): 1026–34.

9. Adams R, Walsh C, Veale D, Bresnihan B, FitzGerald O, Barry M. Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis. Pharmacoeconomics. 2010; 28(6): 477–87.

10. Cohen J. Statistical Power Analysis for the Behavioural Sciences. 2nd ed. Mahwah, NJ. Lawrence Erlbaum, 1988.

11. Kašák, V. Farmakoekonomika a farmakoterapie. [online]. 2009.

12. Karlsson JA, Nilsson JÅ, Neovius M, Kristensen LE, Gülfe A, Saxne T, Geborek P. National EQ-5D tariffs and quality-adjusted life-year estimation: comparison of UK, US and Danish utilities in south Swedish rheumatoid arthritis patients. Ann Rheum Dis. 2011 Dec; 70(12): 2163–6. 

13. Kobelt G, Eberhardt K, Geborek P. TNF inhibitors in the treatment of rheumatoid arthritis in clinical practice: costs and outcomes in a follow up study of patients with RA treated with etanercept or infliximab in southern Sweden. Ann Rheum Dis. 2004 Jan; 63(1): 4–10.

Štítky
Dermatology & STDs Paediatric rheumatology Rheumatology
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#