Análisis de costo-efectividad del abordaje clínico en fase temprana vs. fase establecida en una cohorte de pacientes con artritis reumatoide de una institución prestadora de servicios de salud de cuarto nivel en Colombia

Abstract

IntroductionRheumatoid arthritis (RA) is a high-cost disease, which allows patients to be classified into early or established phase approaches. ObjectiveThe purpose of this work was to perform a cost-effectiveness analysis comparing both phases with patient data at a 6-month time horizon from a third-party payer perspective. Materials and methodsThe population was delimited. The costs and effectiveness of each of the phases were estimated. A decision tree-type economic evaluation model was developed, and the Incremental Cost-Effectiveness Ratio (ICER) was calculated with the respective sensitivity analyses, both deterministic and probabilistic. ResultsIn terms of costs, it was found that for effectiveness in goals, the cost was 85% higher in the established than in the early phase. Similarly, for non-target effectiveness, the cost was 77% higher in the established than in the early phase. On the other hand, the effectiveness results were better in the early phase compared to the established phase. Regarding the ICER, it was determined that the early phase approach saves $2,326,389 COPcte (colombian pesos current currency) per patient in goals at 6 months of treatment, compared to the established phase approach. ConclusionThe clinical approach to early-stage rheumatoid arthritis is a less costly and more effective alternative vs. the established phase, as it generates savings for the third-party payer over a 6-month time horizon, from a third-party payer perspective.