The University of Sheffield
Health Economics and Decision Science

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, progressive, inflammatory disease that affects approximately 0.8% of the adult population. We have been involved in projects to examine the cost effectiveness of newer biologic drugs (Etanercept, Infliximab, Adalimumab and Anakinra) and disease modifying anti-rheumatic drugs (DMARDs). We have been involved in studies to map health state utilities to Health assessment Questionnaire Disability Index (HAQ), a widely used measure of illness in RA. We have also provided health economics support to the NICE clinical guideline for adult RA. [link]

Modelling the cost-effectiveness of TNF-α inhibitors in the management of rheumatoid arthritis: results from the British Society For Rheumatology Biologics Registry

We carried out a model-based evaluation of the cost-effectiveness of TNF-α Inhibitors in the management of rheumatoid arthritis. The project was carried out for the British Society of Rheumatology, and used data from their UK biologics registry. A form of micro-simulation known as individual sampling was developed to simulate the natural history of the disease. The model was used to estimate the cost-effectiveness of TNF-a inhibitors as a class, and to illustrate how this central estimate varied for different sub-groups and treatment protocols.

The cost-effectiveness of drugs for the treatment of RA in the Medicare Drug Replacement Demonstration Project

The Medicare replacement drug demonstration program is a scheme operating between Sept 2004 and Dec 2005 in the US which extends Medicare coverage (primarily for the elderly or disabled) to certain drugs which were not previously covered. Historically, only drugs that are administered in a physician´s office have been covered under Medicare and therefore many new drugs for the treatment of some cancers, multiple sclerosis, rheumatoid arthritis, and pulmonary hypertension as well as other rare and serious diseases have not been covered by Medicare. The pilot scheme will be limited to 50,000 people and serves as a bridge before the US Medicare Modernisation Act is implemented in January 2006.

HEDS has completed a project funded by the National Institute for Health, Agency for Health Care Research and Quality to assess the cost effectiveness of biologic drugs (etanercept, adalimumab and anakinra) compared to the previously covered infliximab, for the treatment of rheumatoid arthritis. This study is a collaboration between HEDS, the MRC Biostatistics Unit (University of Cambridge), the University of British Columbia in Canada and the National Databank for Rheumatic Diseases, Wichita, Kansas.

Publications