Table of Contents
ISRN Rheumatology
Volume 2013, Article ID 256871, 15 pages
Review Article

Investigating the Value of Abatacept in the Treatment of Rheumatoid Arthritis: A Systematic Review of Cost-Effectiveness Studies

Department of Health Economics, National School of Public Health, 196 Alexandras Avenue, 11521 Athens, Greece

Received 24 March 2013; Accepted 29 April 2013

Academic Editors: J. Anguita, J. L. Pérez-Castrillon, and S. Verstappen

Copyright © 2013 Kostas Athanasakis 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. Rheumatoid arthritis is a progressive inflammatory disease that affects greatly patients’ quality of life and demands for aggressive management early on during the course of the disease. The discovery of biologics has equipped rheumatologists with evolutionary treatment tools but has also impacted greatly management costs. Objectives. To conduct a systematic review in order to evaluate the cost effectiveness of abatacept in the treatment of moderate to severe rheumatoid arthritis. Methods. Pubmed, the International Society for Pharmacoeconomics and Outcomes Research Outcomes Research Digest, the National Health System Economic Evaluation Database, and the Database of Abstracts of Reviews of Effects were searched. Results. In total 301 studies were identified and 42 met the inclusion criteria. Half of the selected studies evaluated abatacept in the treatment of rheumatoid arthritis, after failure of or intolerance to tumor necrosis factor alpha inhibitors. Of those, 82% were in favor of abatacept as a cost-effective or dominant strategy versus varying alternatives, whereas 18% favored other treatments. Conclusion. The majority of evidence from the published literature supports that abatacept can be a cost-effective alternative in the treatment of moderate to severe rheumatoid arthritis, especially in patients that have demonstrated inadequate response or intolerance to anti-TNF agents or conventional disease modifying antirheumatic drugs.