Table 5. Cost-effectiveness of biologics in comparison with cDMARD among patients with an insufficient response to at least one TNF inhibitor.
| Biologic | Study | ICER €/QALY (only direct costs) | ICER €/QALY (direct and indirect costs) | Results of deterministic sensitivity analysis €/QALY | Source of research funding |
|---|---|---|---|---|---|
| RTX | Yuan et al. 2010 [42] | 47,931 | - | 57,370–96,012 | BMS |
| Kielhorn et al. 2008 [31] | 28,594 | - | 9,758–67,321 | Roche | |
| Brodszky et al. 2010 [34] | 26,304–46,389 | 31,382–37,266 | - | Center for Public Affairs Studies Foundation and Roche | |
| Hallinen et al. 2010 [54] | 34,269 | - | 24,929–52,929 | Roche | |
| Malottki et al. 2011 [53] | 30,021 | - | 16,220–65,448 | NICE (UK) | |
| IFX | Hallinen et al. 2010 [54] | 40,923 | - | 36,174–48,483 | Roche |
| Malottki et al. 2011 [53] | 51,362 | - | 40,976–98,029 | NICE (UK) | |
| ADA | Hallinen et al. 2010 [54] | 57,713 | - | 48,963–68,930 | Roche |
| Malottki et al. 2011 [53] | 48,801 | - | 39,980–87,216 | NICE (UK) | |
| ETN | Hallinen et al. 2010 [54] | 57,068 | - | 48,294–68,285 | Roche |
| Malottki et al. 2011 [53] | 55,346 | - | 44,248–108,558 | NICE (UK) | |
| Lekander et al. 2013 [25] | - | 74,743 (ETN+cDMARD) | 47,164–113,453 (ETN+DMARD) | Wyeth (now Pfizer) | |
| Lekander et al. 2013 [25] | - | 88,861 (ETN) | 53,769–175,126 (ETN) | Wyeth (now Pfizer) | |
| ABT | Hallinen et al. 2010 [54] | 75,910 | - | 65,232–90,234 | Roche |
| Malottki et al. 2011 [53] | 54,635 | - | 45,671–90,062 | NICE (UK) | |
| Vera-Llonch et al. 2008b [43] | 45,275–49,802 | - | 40,211–79,438 | Not stated, One of authors was an employee of BMS | |
| Yuan et al. 2010 [42] | 41,207 | - | 49,912–81,509 | BMS | |
| ANA | Clark et al. 2004 [22] | 620,109–1 347,287 (ANA➔cDMARDs) | - | 100,378–671,413 | NICE (UK) |
| Clark et al. 2004 [22] | 234,214–292,210 (cDMARDs➔ANA) | - | 82,533–216,370 | NICE (UK) | |
| TNFi | Lekander et al. 2013 [25] | 101,618 (TNFi+cDMARD) | 84,363 (TNFi+cDMARD) | 50,316–134,016 (TNFi+cDMARD) | Wyeth (now Pfizer) |
| Lekander et al. 2013 [25] | 143,745 (TNFi) | 126,813 (TNFi) | 71,022–328,903 (TNFi) | Wyeth (now Pfizer) |
➔ = switch to next treatment in case of an inadequate response, ABT = abatacept, ADA = adalimumab, ANA = Anakinra, BMS = Bristol-Myers Squibb, cDMARD = conventional disease-modifying antirheumatic drugs, ETN = etanercept, ICER = Incremental cost-effectiveness ratio, IFX = infliximab, NICE = National Institute for Health and Care Excellence, QALY = quality-adjusted life year, RTX = rituximab, TNFi = TNF inhibitor