Biological drugs are used for the treatment of severe rheumatoid arthritis (RA). The high costs of such treatment have drawn attention to the economic appropriateness of the use of biological drugs. There are no Danish studies of the real costs of present clinical practice. The purpose of this study was to compare the actual costs of RA treatment for the three most commonly used biological drugs.
Data were collected from three Danish hospitals. The study is a cost analysis designed as a retrospective cohort study using data from medical records (n = 198).
The costs of infliximab varied due to dose escalation from 78,660 DKK at one hospital to 120,657 DKK at another hospital. Treatment with either etanercept or adalimumab will tend to cost the same as or less than treatment with infliximab, when infliximab doses exceed the standard dose (3 mg/kg), and treatment breaks amount to at least 10%. At one hospital treatment breaks reduced the consumption of etanercept and adalimumab by 20%.
Actual medicine expenses for treatment of RA with infliximab, etanercept and adalimumab tend to be equal. Consequently, there is no economic rationale for basing the choice of drug on costs calculated on the basis of standard dosage. Instead, the choice should be based on considerations of efficacy, safety, patient needs and the treatment feasibility.