An analysis of the costs and treatment success of etanercept in juvenile idiopathic arthritis: results from the Dutch Arthritis and Biologicals in Children register

Femke H. M. Prince*, Esther W. de Bekker-Grob, Marinka Twilt, Marion A. J. van Rossum, Esther P. A. H. Hoppenreijs, Rebecca ten Cate, Yvonne Koopman-Keemink, Simone L. Gorter, Hein Raat, Lisette W. A. van Suijlekom-Smit

*Corresponding author for this work

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Abstract

Objective. To analyse and report the costs and effects of etanercept therapy in patients with JIA. Methods. Forty-nine JIA patients were evaluated by means of the JIA core set at the start of etanercept and after 3, 15 and 27 months of therapy. At the same time-points, parents of the patients were asked to complete the Health Utility Index Mark 3 (HUI3). Direct medical costs were collected for 1 year before and 27 months after the start of etanercept and compared with gain in utility. Results. Mean total direct medical costs after the start of etanercept were on average 12 478 euros per patient-year compared with 3720 euros before start. The cost analysis showed that three-quarters of total direct medical costs were from etanercept itself. Other direct medical costs, such as costs concerning hospitalization and concomitant medication, decreased compared with the costs in the period before start of etanercept. Especially a great reduction of consultations at the outpatient clinic was seen. Utility was 0.53 before start of etanercept, according to the multi-attribute utility function of the HUI3 on a scale from 0 (dead) to 1 (perfect health). After 27 months, utility was 0.78. In accordance, also all JIA core set response variables improved significantly over 27 months of etanercept treatment. Conclusions. Although costs of etanercept therapy are substantial, the gain in utility is even more impressive. Considering that these JIA patients were previously refractory to conventional treatment including MTX, and were at risk of long-time disability and pain, costs are justifiable.
Original languageEnglish
Pages (from-to)1131-1136
JournalRheumatology
Volume50
Issue number6
DOIs
Publication statusPublished - Jun 2011

Keywords

  • Juvenile idiopathic arthritis
  • Paediatric rheumatology
  • National register study
  • Etanercept
  • Tumour necrosis factor-alpha
  • Biologic
  • Treatment costs
  • Cost-effectiveness
  • Cost-utility
  • Health utilities index

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