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International Journal of Inflammation
Volume 2013, Article ID 581409, 8 pages
Clinical Study

Cost Effectiveness of TNF- Inhibitors in Rheumatoid Arthritis

1Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta
2Rheumatology, Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta

Received 11 June 2013; Revised 29 August 2013; Accepted 15 September 2013

Academic Editor: Jean-Marc Cavaillon

Copyright © 2013 Cynthia Said et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. TNF- inhibitors have shown to be effective in reducing disease activity and improving the quality of life. Due to the high costs associated with acquisition of this treatment, this study was undertaken to evaluate the ICER of TNF- antagonists (etanercept, adalimumab, and infliximab) in improving the quality of life. Methods. The HAQ and SF-36 were administered at phases 1, 2, and 3, in order to assess the improvement in the QOL. Suppression of disease activity was assessed through the DAS-28. Results. Statistically significant improvements () were noted for the SF-36 and HAQ after 3 months and for the DAS-28 after 6 months of TNF- inhibitor therapy. The mean ICER per 10% improvement in the HAQ, DAS-28, and SF-6D were €1976.5, €2086.5, and €2316.4, respectively, following 6 months of TNF- intervention. Most favorable ICERs were reported from a patient who had to undergo surgical intervention whilst on DMARD therapy. Conclusion. Significant improvement was observed in patients’ quality of life, after a short timeframe of 6 months. Such data is useful information in the light of convincing policy makers, in terms of providing access to the medications to individual patients on national health service schemes.