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VBCR - August 2015, Volume 4, No 4 - Value Propositions

A study comparing 2 standard rituximab regimens in the treatment of long-standing rheumatoid arthritis (RA) showed that retreatment as needed was associated with higher quality of life (QOL) at lower cost than a fixed retreatment schedule. Regimen 1 consisted of rituximab 1 gm administered intravenously twice, 2 weeks apart, with retreatment given at clinical relapse; the more intensive regimen 2 began with the customary 2-week dosage followed by a full treatment cycle at 6 months unless remission had occurred.

For this observational retrospective study, Luca Quartuccio, MD, PhD, University Hospital Santa Maria della Misericordia, Udine, Italy, and colleagues evaluated 102 patients in 3 hospitals, following them for at least 12 months. The study group comprised 90 women and 12 men, with an average age of 62.1 years, who had long-standing moderate-to-severe RA. Patients had had an inadequate response to nonbiologic and/or biologic disease-modifying antirheumatic drugs; 47 patients were on regimen 1, and 55 patients were on regimen 2.

Using a Markov model, a cost-effectiveness analysis was performed and results showed that regimen 1 was less expensive than regimen 2. Researchers also found that regimen 1 had an estimated discounted mean cost per patient over 10 years of about €54,000 ($59,000) whereas regimen 2 cost about €73,000 ($79,000). Regimen 1 was cost-effective in 95.1%, 93.5%, and 93.2% of samples in the 10-, 20-, and 30-year scenarios, respectively. According to the authors, “Regimen 1 was dominant in being less costly and associated with a higher QOL when compared to regimen 2 in all scenarios.” Quartuccio L, et al. Arthritis Care Res. 2015;67(7):947-955.

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Last modified: August 26, 2015
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