OBJECTIVES

Rheumatoid arthritis (RA) and systemic juvenile arthritis (sJA) are the most frequent rheumatic diseases in adults and adolescents, consequently. Biologics disease modifying antirheumatic drugs (bDMARDs) are effective in treatment of RA and sJA.

METHODS

The aim of the study was to perform health-economic analysis of tocilizumab for subcutaneous and intravenous injections in patients with RA and sJA comparing to TNF-α inhibitors. Latest meta-analyses do not show significant differences between bDMARDs in the effectiveness in treatment RA and sJA. Cost-minimizing analysis was used from the perspective of healthcare system (direct medical costs) with the modelling horizon – 1 year. We included into the model cost of RA and sJA bDMARDs, cost of adverse events correction (including reactivation of tuberculosis) and costs of laboratory and instrumental diagnostics. Sensitivity analysis was done to assess how the changes in model parameters influence the results.

RESULTS

Cost minimizing ratio of tocilizumab (subcutaneous form) in RA patients comparing to adalimumab (Humira), сertolizumab pegol, golimumab were 111536 RUR; 129094 RUR; 85244 RUR, consequently favor to tocilizumab. Tocilizumab was less costly comparing to adalimumab (Humira), certolizumab pegol, golimumab by 12.8%, 14.5%, 10,0%, consequently. Cost minimizing ratio of tocilizumab in RA patients comparing to adalimumab (Dalibra), etanercept, infliximab (Remicade) were 40497; 54355; 28419 RUR in favour to comparators. Tocilizumab was more costly comparing to adalimumab (Dalibra) etanercept, infliximab (Remicade) by 5.6%, 7.7%, 3.9 %, consequently. Cost minimizing ratio of tocilizumab in sJA patients comparing to kanakinumab, adalimumab (Humira) and adalimumab (Dalibra) were 6535234 RUR; 478297 RUR and 323263 RUR. Tocilizumab was less costly comparing to kanakinumab, adalimumab (Humira) and adalimumab (Dalibra) by 93.3%; 50.6% and 41.1 %, consequently. The share of bDMARDs in total costs structure was 84%-96%.

CONCLUSIONS

Tocilizumab is economically reasonable comparing to others TNF-α inhibitors in patients with RA and sJA.