YAKHAK HOEJI (약학회지)

The Pharmaceutical Society of Korea (대한약학회)
권호 표지

Cost-Effectiveness Analysis of Etanercept in the Treatment of Methotrexate-resistant Rheumatoid Arthritis

메토트렉세이트 치료에 실패한 류마티스관절염 환자에서 에타너셉트 사용에 대한 비용-효과 분석

  • 김종주 (숙명여자대학교 임상약학대학원) ;
  • 박은자 (한국보건사회연구원 보건의료연구실) ;
  • 박세정 (한국보건사회연구원 보건의료연구실) ;
  • 성윤경 (한양대학교 의과대학) ;
  • 배상철 (한양대학교 의과대학) ;
  • 이의경 (한국보건사회연구원 보건의료연구실)
  • Published : 2006.04.01
Download PDF
⟨ Previous Next ⟩

Abstract

A cost effective analysis was performed for comparing leflunomide+methotrexate, etanercept monotherapy and etanercept+methotrexate for 6 months. For the patients with methotrexate-resistant RA, ACR20 data were extracted from the published clinical trials searched from Pubmed. The direct medical cost was estimated based on ACR guideline and Korean National Health Insurance reimbursement. Combination therapy of etanercept+methotrexate was found to be more cost-effective than etanercept monotherapy, which meant it was a better therapeutic strategy for methotrexate- resistant RA.

Keywords

References

  1. American College of Rheumatology Subcommittee on Rheumatoid-Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum. 46, 328 (2002) https://doi.org/10.1002/art.10148
  2. Lubeck, D. P. : Patient-reported outcomes and their role in the assessment of rheumatoid arthritis. Pharmacoeconomics 22, 27 (2004) https://doi.org/10.2165/00019053-200422001-00004
  3. Lipsky, P. E. : Rheumatoid Arthritis. In: Braunwald et al., eds. Harrison's Principles of Internal Medicine. 15th ed. Mc Graw Hill, p1928 (2004)
  4. Pugner, K. M., Scott, D. I., Holmes, J. W. and Hieke, K. : The cost of rheumatoid arthritis: an international long-term view. Semin. Arthritis. Rheum. 29, 305 (2000) https://doi.org/10.1016/S0049-0172(00)80017-7
  5. Kvien, T. K. : Epidemiology and burden of illness of rheumatoid arthritis. Pharmacoeconomics 22, 1 (2004)
  6. Young, A., Dixey, J., Kulinskaya, E., Cox, N., Davies, P., Devlin, J., Emery, P., Gough , A., James, D., Prouse, P., Williams, P. and Winfield, J. : Which patients stop working because of rheumatoid arthritis- Results of five years' follow up in 732 patients from the Early RA Study (ERAS). Ann. Rheum. Dis. 61, 335 (2002) https://doi.org/10.1136/ard.61.4.335
  7. Moreland, L. W., Schiff, M. H., Baumgartner, S. W., Tindall, E. A., Fleischmann, R. M., Bulpitt, K. J., Weaver, A. L., Keystone, E. C., Furst, D. E., Mease, P. J., Ruderman, E. M., Horwitz, D. A., Arkfeld, D. G., Garrison, L., Burge, D. J., Blosch, C. M., Lange, M. L., McDonnell, N. D. and Weinblatt, M. E. : Etanercept therapy in rheumatoid arthritis: a randomized, controlled trial. Ann. Intern. Med. 130, 478 (1999) https://doi.org/10.1001/archinte.130.4.478
  8. Klareskog, L., van der Heijde, D., de Jager, J. P., Gough, A., Kalden, J., Malaise, M., Martin Mola, E., Pavelka, K., Sany, J., Settas, L., Wajdula, J., Pedersen, R., Fatenejad, S. and Sanda, M. : Therapeutic effect of the combination of etanercept and methotrexate copmpared with each treatment alone in patients with rheumatoid arthritis: double-blind randomized controlled trial. Lancet 363, 675 (2004)
  9. Michaud, K., Messer, J., Choi, H. K. and Wolfe, F. : Direct medical costs and their predictors in patients with rheumatoid arthritis. Arthritis & Rheumatism 48, 2750 (2003) https://doi.org/10.1002/art.11439
  10. 오승일, 윤형란, 배상철 : 류마티스 관절염 치료시 저용량의 코르 티코스테로이드, 비스테로이드성 항염제 사용의 비용-효과 분석. 대한류마티스학회지 (2002)
  11. 윤형란, Corzillus, M., 김성윤, 배상철 : 류마티스 관절염 치료 시 비스테로이드성 소염제 단독, 위장관 부작용 예방 약제 병용 투여 및 COX-2 특이 억제제 사용의 한국 비용-효과 분석. 대한 내과학회지, 60(6), 574 (2001)
  12. Brennan, A., Bansback, N., Reynilds, A. and Conway, P. : Modeling the cost-effectiveness of etanercept in adults with rheumatoid arthritis in the UK. Rheumatology (Oxford) 43, 62 (2004) https://doi.org/10.1093/rheumatology/keg451
  13. Lyseng-Williamson, K. A. and Plosker. G. L. : Etanercept; A pharmacoeconomic review of its use in rheumatoid arthritis. Pharmacoeconomics 22, 1071 (2004) https://doi.org/10.2165/00019053-200422160-00004
  14. Kobelt, G., Eberhardt, K. and Geborek, P. : TNF inhibitors in the treatment of rheumatoid arthritis in clinical practice: cost and outcomes in a follow up study of patients with RA treated with etanercept or infliximab in southern Sweden. Ann. Rheum. Dis. 63, 4 (2004) https://doi.org/10.1136/ard.2003.010629
  15. Choi, H. K., Seeger, J. D. and Kuntz, K. M. : A costeffectiveness of treatment options for patients with methotrexate- resistant rheumatoid arthritis. Arthritis & Rheumatism 43, 2316 (2000) https://doi.org/10.1002/1529-0131(200010)43:10<2316::AID-ANR20>3.0.CO;2-6
  16. Choi, H. K., Seeger, J. D. and Kuntz, K. M. : A costeffectiveness of treatment options for methotrexate-naive rheumatoid arthritis. J. Rheumatol. 29, 1156 (2002)
  17. Maddison, P., Kiely, P., Kirkham, B., Lawson, T., Moots, R., Proudfoot, D., Reece, R., Scott, D., Sword, R., Taggart, A., Thwaites, C. and Williams, E. : Leflunomide in rheumatoid arthritis: recommendations through a process of consensus. Rheumatology 44, 280 (2005) https://doi.org/10.1093/rheumatology/keh500
  18. Cohen, J. D., Zaltni, S., Kaiser, M. J. and Bozonnat, M. C., Jorgensen, C., Daures, J. P. and Sany, J. : Secondary addition of methotrexate to partial responders to etanercept alone is effective in severe rheumatoid arthritis. Ann. Rheum. Dis. 63, 209 (2004) https://doi.org/10.1136/ard.2003.013532
  19. Published by authority of the Board of Directors of the American Society of Health-System Pharmacists: American Hospital Formulary Service (AHFS) Drug Information. Bethesda, MD .American Society of Health-System Pharmacists (2005)
  20. Weinblatt, M. E., Kremer, J. M., Bankhurst, A. D., Bulpitt, K. J., Fleischmann, R. M., Fox, R. I., Jackson, C. G., Lange, M. and Burge, D. J. : A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N. Eng. J. Med. 340, 253 (1999) https://doi.org/10.1056/NEJM199901283400401
  21. Kremer, J. M., Genovese, M. C., Cannon, G. W., Caldwell, J. R., Cush, J. J., Furst, D. E., Luggen, M. E., Keystone, E, Weisman, M. H., Bensen, W. M., Kaine, J. L., Ruderman, E. M., Coleman, P., Curtis, D. L., Kopp, E. J., Kantor, S. M., Waltuck, J., Lindsley, H. B., Markenson, J. A., Strand, V., Crawford, B., Fernando, I., Simpson, K. and Bathon, J. M. : Concomitant leflunomide therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate. Ann. Intern. Med. 137, 726 (2002) https://doi.org/10.1001/archinte.137.6.726
  22. 식품의약품안전청. 의약품 안전성 서한. 2005.2.14
  23. The British Society for Rheumatology : Update of BSR guideline for prescribing TNF${\alpha}$ blockers in adults with rheumatoid arthritis. July 2004
  24. 식품의약품안전청 : TNF길항제 사용 시 잠복 결핵 치료 지침. 2004.12
  25. Genovese, M. C., Cohen, S., Moreland, L., Lium, D., Robbins, S., Newmark, R. and Bekker, P. : Combination therapy with etanercept and anakinra in the treatment of patients with rheumatoid arthritis who have been treated unsuccessfully with methotrexate. Arthritis & Rheumatism 50, 1412 (2004) https://doi.org/10.1002/art.20221
  26. Kavanaugh, A., Heudebert, G., Cush, J. and Jain, R. : Cost evaluation of novel therapeutics in rheumatoid arthritis (CENTRA): adecision analysis model. Semin. Arthritis. Rheum. 25, 297 (1996) https://doi.org/10.1016/S0049-0172(96)80016-3
  27. Maetzel, A., Tugwell, P., Boers, M., Guillemin, F., Coyle, D., Drummond, M., Wong, J. B. and Gabriel, S. E. : Economic evaluation of programs or interventions in the management of rheumatoid arthritis: defining a consensus-based reference case. J. Rheumatol. 30, 891 (2003)
  28. Gabriel, S., Drummond, M. and Maetzel, A. : OMERACT 6 Economics Working Group report: a proposal for a reference case for economic evaluation in rheumatoid arthritis. J. Rheumatol. 30, 886 (2003)