Impact of etanercept on the costs of rheumatoid arthritis (RA): Results from a French observational study

Abstract

Introduction Economical impact of rheumatoid arthritis (RA) has been widely modified thanks to TNF inhibitors. Our study aims to estimate the impact etanercept prescription, in term of health resources consumption, within a regional cohort of French RA patients. Methods The study included 148 RA patients, with a mean follow-up duration of 343 days before and after etanercept initiation. Data were anonymously collected from ERASME database of French Health Insurance in Midi-Pyrénées region. A patient-by-patient microcosting approach was performed. Results The average annual cost per patient, attributable to RA, was 2.8 times higher after treatment by etanercept than before (15,148.57€ versus 5248.95€). We observed a rise in pharmaceutical costs, from 11.7% of direct medical costs before to 69.7% after etanercept initiation (120.12€ versus 9995.23€). We observed a small decrease particularly for NSAIDs (142.14€ versus 102.21€) and physiotherapy (286.40€ versus 138.77€). Attributable act costs and indirect costs did not differ before and after etanercept initiation. Discussion In this short-term study, initiation of etanercept in RA patients did not come along with a decrease of consumption of health resources. Long-term studies are needed to reveal a potential economical advantage as a consequence of the clinical, structural and functional efficacy of anti-TNF.