European Study: All Biologics Improve Quality of Life in RA, But Rituximab Is Cost-Effective

A recent study, based on real-world experience in Bulgaria, looked to compare the quality of life (QOL) benefits and the cost of biologic therapeutic options for the treatment of rheumatoid arthritis (RA).

In the observational study, researchers enrolled 124 patients treated with biological medicines after receiving prior treatment with conventional drugs from 2012 to 2016 at a university hospital in Bulgaria. QOL was assessed through the European Quality 5-Dimensions (EQ5D) questionnaire at the beginning of therapy, after 6 months, and 1 year.

Physicians were able to choose the biologic medicine prescribed to their patient based on clinical status of the patients and the available medicines on the hospital’s reimbursement list. Patients in the study took the following therapies: tocilizumab (n = 30), certolizumab pegol (n = 16), golimumab (n = 22), etanercept (n = 20), adalimumab (n = 20), and rituximab (n = 16).

Click here to read more about biologic therapies in RA.

To evaluate the cost effectiveness of each respective product, researchers built a decision-tree model using software to compare the yearly pharmacotherapy cost with the changes in EQ5D scores after 1 year of biologic therapy.

Through the evaluation, researchers confirmed that the QOL improvement produced by biologic therapy is statistically significant. Specifically, as measured by EQ5D, QOL improves quickly at the beginning of therapy and subsequently slows down toward the end of 1 year of therapy.

However, though each drug was found to improve the QOL of RA patients, only rituximab was identified to be cost-effective.

“Biological medicines appear not to be cost-effective due to their high incremental cost-effectiveness ratio,” the authors noted. Rituximab’s incremental cost-effectiveness ratio falls close to being 3 time the gross domestic product per capita threshold.

The researchers concluded that rituximab should be considered as a preferred biologic treatment for RA therapy, though treatment of RA with any biologic medication improves quality of life significantly.

Reference

Boyadzieva V, Stoilov N, Stoilov R, et al. Quality of life and cost study of rheumatoid arthritis therapy with biological medicines. Front Pharmacol. 2018;9:794. doi: 10.3389/fphar.2018.00794.