OBJECTIVES: Rheumatoid arthritis (RA) is a chronic, progressive disease characterized by joint inflammation and systemic effects. This study evaluates the cost-effectiveness of filgotinib, a selective oral JAK1 inhibitor with a proven efficacy and safety profile, combined with methotrexate for treating patients with moderate to severe active RA who had an inadequate response to disease-modifying antirheumatic drugs (DMARDs) in Greece, compared to tofacitinib.

METHODS: The economic model used to assess the cost-effectiveness of filgotinib with methotrexate evaluates health outcomes and associated costs from a third-party payer perspective. It incorporates a lifetime horizon of up to 100 years, and applies a 3.5% discount rate for costs, life years, and quality-adjusted life years (QALYs). Clinical inputs, derived from a network meta-analysis, ensure a robust comparison across treatments, integrating data from multiple studies. All economic inputs are sourced from official resources to maintain relevance and reliability within current treatment practices and cost structures.

RESULTS: The comparative economic analysis shows that using filgotinib as the first-line advanced treatment offers significant cost advantages over the tofacitinib. Although both treatments yield identical life years of 14.82, filgotinib achieves this at a total cost of €76,823, which is €1,960 less than the €78,783 required for tofacitinib. The QALYs are nearly the same for both strategies, with a marginal difference of 0.001 QALY slightly favoring filgotinib. Despite this small difference in QALYs, the lower cost of the filgotinib strategy clearly demonstrates its economic superiority, establishing it as the dominant JAK1 inhibitor treatment option for moderate to severe RA.

CONCLUSIONS: Filgotinib is cost-effective and dominates over tofacitinib in the Greek healthcare environment, providing comparable clinical outcomes with significant cost savings for the third-party payer. This analysis supports the adoption of filgotinib as a preferred treatment strategy for RA, emphasizing its value in combining clinical efficacy with economic efficiency.