TY - JOUR
T1 - Treating to the target of remission in early rheumatoid arthritis is cost-effective: results of the DREAM registry
AU - Vermeer, M.
AU - Kievit, Wietske
AU - Kuper, Hillechina H.
AU - Braakman-Jansen, Louise Marie Antoinette
AU - Bernelot Moens, Hein J.
AU - Zijlstra, Theo
AU - den Broeder, Alfons A.
AU - van Riel, Piet L.C.M.
AU - Fransen, Jaap
AU - van de Laar, Mart A F J
N1 - http://www.biomedcentral.com/content/pdf/1471-2474-14-350.pdf
PY - 2013/12/13
Y1 - 2013/12/13
N2 - Background
Where health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the costeffectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care in early rheumatoid arthritis (RA).
Methods
We used real-life data from comparable cohorts in the Dutch Rheumatoid Arthritis
Monitoring (DREAM) registry: the DREAM remission induction cohort (treat-to-target, T2T) and the Nijmegen early RA inception cohort (usual care, UC). Both cohorts were followed prospectively using the DREAM registry methodology. All patients fulfilled the American College of Rheumatology criteria for RA and were included in the cohort at the time of diagnosis. The T2T cohort was treated according to a protocolised strategy aiming at remission (Disease Activity Score in 28 joints (DAS28) < 2.6). The UC cohort was treated without DAS28-guided treatment decisions. EuroQol-5D utility scores were estimated from the Health Assessment Questionnaire. A health care perspective was adopted and direct
medical costs were collected. The incremental cost effectiveness ratio (ICER) per patient in remission and incremental cost utility ratio (ICUR) per quality-adjusted life year (QALY) gained were calculated over two and three years of follow-up.
Results
Two year data were available for 261 T2T patients and 213 UC patients; an extended followup of three years was available for 127 and 180 patients, respectively. T2T produced higher remission percentages and a larger gain in QALYs than UC. The ICER was �
AB - Background
Where health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the costeffectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care in early rheumatoid arthritis (RA).
Methods
We used real-life data from comparable cohorts in the Dutch Rheumatoid Arthritis
Monitoring (DREAM) registry: the DREAM remission induction cohort (treat-to-target, T2T) and the Nijmegen early RA inception cohort (usual care, UC). Both cohorts were followed prospectively using the DREAM registry methodology. All patients fulfilled the American College of Rheumatology criteria for RA and were included in the cohort at the time of diagnosis. The T2T cohort was treated according to a protocolised strategy aiming at remission (Disease Activity Score in 28 joints (DAS28) < 2.6). The UC cohort was treated without DAS28-guided treatment decisions. EuroQol-5D utility scores were estimated from the Health Assessment Questionnaire. A health care perspective was adopted and direct
medical costs were collected. The incremental cost effectiveness ratio (ICER) per patient in remission and incremental cost utility ratio (ICUR) per quality-adjusted life year (QALY) gained were calculated over two and three years of follow-up.
Results
Two year data were available for 261 T2T patients and 213 UC patients; an extended followup of three years was available for 127 and 180 patients, respectively. T2T produced higher remission percentages and a larger gain in QALYs than UC. The ICER was �
KW - METIS-299855
KW - IR-88428
U2 - 10.1186/1471-2474-14-350
DO - 10.1186/1471-2474-14-350
M3 - Article
SN - 1471-2474
VL - 14
SP - -
JO - BMC musculoskeletal disorders
JF - BMC musculoskeletal disorders
IS - 350
ER -