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Pharmacoeconomics. 2012 Dec 1;30(12):1145-56. doi: 10.2165/11596490-000000000-00000.

Cost effectiveness of therapeutic interventions in ankylosing spondylitis: a critical and systematic review.

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1
Universit Pierre et Marie Curie Paris VI, GRC-UMPC 08 (EEMOIS), Paris, France.

Abstract

OBJECTIVES:

This report reviews the cost effectiveness of different therapeutic interventions used in the treatment of ankylosing spondylitis (AS).

METHODS:

We performed a systematic search of the databases MEDLINE via PubMed, EMBASE and the Cochrane Library and used hand-searching to identify articles on cost effectiveness of therapies for adult patients with AS published up to November 2010.

RESULTS:

Of 135 articles, 13 studies were analysed. Two articles were on physical therapies, one article was on NSAIDs and ten articles were on tumour necrosis factor (TNF) inhibitors (infliximab = 6, etanercept = 2, infliximab and etanercept = 1 and adalimumab = 1). Of the latter, no article directly compared TNF inhibitors. Articles showed substantial heterogeneity in methodological approaches and thus results, which prevented us from any extensive comparison, data pooling or meta-analysis. The incremental cost-effectiveness ratio (ICER) for spa-exercise treatment was &U20AC;7465 (95% CI 3294, 14 686) per QALY. The ICERs for infliximab, etanercept and adalimumab were &U20AC;5307-237 010, &U20AC;29 815-123 761 and &U20AC;7344-33 303 per QALY, respectively.

CONCLUSIONS:

Modelling treatment strategies in chronic relapsing diseases such as AS presents specific challenges, as reflected in the variation in the cost-effectiveness results reported. Although quite variable, the cost-effectiveness ratios for AS therapies remain within an acceptable range.

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