Economic Evaluations in Axial Spondyloarthritis

Parallel to the availability of biologic disease-modifying drugs (bDMARDs) in axial spondyloarthritis (axSpA), questions on the affordability of the management of axSpA were raised. A health economic evaluation is a tool to compare costs and the benefits of alternative interventions. Modeling the long-term (treated and untreated) course of health of patients constitutes the core of an economic analysis. Most economic evaluations in axSpA conclude that bDMARDs in patients from Western societies with active disease are cost-effective, especially when accounting for improved work participation. Notwithstanding, substantial uncertainty around the main cost-effectiveness estimates exists, mainly related to assumptions about the long-term course of axSpA when modeling the disease. Focusing clinical and epidemiologic research in axSpA on these areas of uncertainty will contribute to the validity of economic evaluations and thus efficiency of our healthcare system.