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Is there a pharmacoeconomic argument supporting the use of tumor necrosis factor inhibitors in early rheumatoid arthritis?

Nature Clinical Practice Rheumatology volume 2, pages 346–347 (2006)Cite this article

Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease that has a serious impact on patients' lives. The most notable therapeutic advance for patients with systemic inflammatory disorders over the last half century is the development of inhibitors of the key proinflammatory cytokine tumor necrosis factor (TNF). TNF inhibitors have proven highly effective not only in improving the signs and symptoms of disease, but also in inhibiting the progression of joint damage, improving patients' quality of life, and preserving their functional status.1 In combination with methotrexate, TNF inhibitors have come to represent a 'gold standard' for the treatment of severe RA.

The major concern relating to the use of TNF inhibitors in the clinic is their relatively high acquisition costs. In the US, the average 2005 wholesale price for 1 year of therapy with a TNF inhibitor exceeded US$15,000, which is substantially higher than the cost of other, older therapeutic agents. For example, the yearly cost of generic methotrexate at a typical dose of 17.5 mg/week is approximately $500. Thus, there has been an increased emphasis on pharmacoeconomic analyses as a means of justifying therapy with TNF inhibitors.2,3

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Authors and Affiliations

  1. Professor of Medicine and the Director of the Center for Innovative Therapy in the Division of Rheumatology, Allergy, and Immunology at the University of California San Diego, La Jolla, CA, USA

    Arthur Kavanaugh

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  1. Arthur Kavanaugh
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Correspondence to Arthur Kavanaugh.

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The author declares no competing financial interests.

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Kavanaugh, A. Is there a pharmacoeconomic argument supporting the use of tumor necrosis factor inhibitors in early rheumatoid arthritis?. Nat Rev Rheumatol 2, 346–347 (2006). https://doi.org/10.1038/ncprheum0218

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