Economic impact of a biological therapy prioritization protocol for rheumatoid arthritis and spondyloarthritis

• Autores: María José Cumbraos Sánchez, Mercedes Gimeno Gracia, Pilar Del Río Martínez, Concepción Delgado Beltrán, Tránsito Salvador Gómez
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 19, Nº. 5, 2017, págs. 3-3
• Idioma: inglés
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• Resumen

  • Objective: To evaluate the economic impact of a biological therapy prioritization protocol designed by a multidisciplinary team including hospital pharmacists to promote the efficient use of biological drugs to treat rheumatic arthritis (RA) and spondyloarthritis (SpA). A secondary aim was to evaluate the impact of weekly clinical sessions in which expert rheumatologists evaluated candidates for treatment initiation or switch on a case-by-case basis.

    Method: Observational, retrospective analysis comparing the costs of biological therapies during the pre-protocol period (2010) and the post-protocol period (2011-2014). Economic impact was measured by calculating the cumulative cost of biological therapy per patient in the second semester of each year, using hospital purchase prices. We analyzed adult patients with rheumatic arthritis or spondyloarthritis treated with etanercept, adalimumab, abatacept, infliximab, tocilizumab, and rituximab. The clinical sessions were analyzed for 2014, which is when they started.

    Results: In the second semester of 2010, prior to the implementation of the protocol, the average cost of biological therapies was €6,331 per patient-semester.

    In 2014, the cost was €5,237 per patient-semester. The cumulative effect of protocol implementation was thus €1,094 per patient-semester. Forty-one clinical sessions were held in 2014 and 138 patients were assessed; 80.5% of treatments analyzed were accepted and 19.5% were rejected.

    Conclusion: Use of a biological therapy prioritization protocol to prescribe biological drugs, combined with a case-by-case study by an expert group of rheumatologists, can be an efficient tool for promoting the rational use of biological therapies in RA and SpA.