A cost effectiveness analysis of cyclosporine in rheumatoid arthritis.
To perform a cost effectiveness analysis of cyclosporine (CyA) in the treatment of rheumatoid arthritis (RA).
Five randomized controlled parallel group clinical trials were selected for metaanalysis.
A fixed effects model was used to calculate the treatment effects among the studies.
An incremental economic analysis was performed from both a societal perspective and the perspective of Ontario Ministry of Health (MOH).
A placebo comparison and 2 head to head comparisons were performed.
The total treatment cost was calculated for a typical patient based on a modified intent to treat approach modelled over a one year period.
CyA produced a 25% or greater improvement in tender joint count in 35% of the patients relative to 17% of patients receiving placebo.
There was no significant difference in improvement between CyA and azathioprine (Aza) or D-penicillamine (D-Pen).
From the perspective of the Ontario MOH, the annual incremental cost of achieving the same level of improvement between CyA and Aza was found to be $1,473, and between CyA and D-Pen, $1,618 ; the annual incremental cost effectiveness ratio per patient improved of adopting CyA over placebo was $11,547.
From a societal perspective, the incremental cost of CyA was $2,886 and $3,731 between Aza and D-Pen, respectively.
The annual incremental cost effectiveness ratio against placebo was $20,698.
Given budgetary constraints on provincial drug plans, guidelines ...
Mots-clés Pascal : Polyarthrite rhumatoïde, Homme, Ciclosporine, Chimiothérapie, Traitement, Analyse coût efficacité, Economie santé, Chronique, Immunomodulateur, Antirhumatismal, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune
Mots-clés Pascal anglais : Rheumatoid arthritis, Human, Chemotherapy, Treatment, Cost efficiency analysis, Health economy, Chronic, Immunomodulator, Antirheumatic agent, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0214775
Code Inist : 002B02L. Création : 199608.