Impact of etanercept on the costs of rheumatoid arthritis (RA): Results from a French observational study

Introduction: Economical impact of rheumatoid arthritis (RA) has been widely modified thanks to TNF inhibitors. Our study aims to estimate the impact etanercept prescription, in term of health resources consumption, within a regional cohort of French RA patients. Methods: The study included 148 RA patients, with a mean follow-up duration of 343 days before and after etanercept initiation. Data were anonymously collected from ERASME database of French Health Insurance in Midi-Pyrenees region. A patient-by-patient microcosting approach was performed. Results: The average annual cost per patient, attributable to RA, was 2.8 times higher after treatment by etanercept than before (15,148.57(sic) versus 5248.95(sic)). We observed a rise in pharmaceutical costs, from 11.7% of direct medical costs before to 69.7% after etanercept initiation (120.12(sic) versus 9995.23(sic)). We observed a small decrease particularly for NSAIDs (142.14(sic) versus 102.21(sic)) and physiotherapy (286.40(sic) versus 138.77(sic)). Attributable act costs and indirect costs did not differ before and after etanercept initiation. Discussion: In this short-term study, initiation of etanercept in RA patients did not come along with a decrease of consumption of health resources. Long-term studies are needed to reveal a potential economical advantage as a consequence of the clinical, structural and functional efficacy of anti-TNF. (c) 2007 Elsevier Masson SAS. All rights reserved.