Pharmacoeconomic analysis of Metoject® in the treatment of rheumatoid arthritis in Spain
Análisis farmacoeconómico de Metoject® en el tratamiento de la artritis reumatoide en España
Carlos Crespoa,b,
, Max Brosaa, Jordi Galvánc, Jordi Carbonelld,e, Jordi Maymód,e, José Luis Marencof, Javier del Pino-Montesg, Alberto Alonsoh, Carlos Rodríguezi
Corresponding author
a Oblikue Consulting, Barcelona, Spain
b Departamento de Estadística, Universidad de Barcelona, Barcelona, Spain
c Departamento Médico, Laboratorios Gebro Pharma, Barcelona, Spain
d Hospital del Mar, Barcelona, Spain
e Hospital de la Esperanza, Barcelona, Spain
f Hospital Universitario de Valme, Sevilla, Spain
g Hospital Universitario de Salamanca, Salamanca, Spain
h Hospital de Cruces, Bilbao, Spain
i Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
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array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112491" "palabras" => array:3 [ 0 => "Methotrexate" 1 => "Cost-effectiveness" 2 => "Quality of life" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112490" "palabras" => array:3 [ 0 => "Metotrexato" 1 => "Coste-efectividad" 2 => "Calidad de vida" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to compare the clinical and economic consequences of using subcutaneous methotrexate (Metoject<span class="elsevierStyleSup">®</span>) with respect to oral methotrexate in the management of rheumatoid arthritis (RA) in Spain.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A cost-effectiveness analysis was performed to compare early treatment of RA using a Markov model. The model allowed us to estimate long term efficacy of RA treatment based on data from the literature and expert opinion, and to combine this data with costs of managing RA in Spain. The perspective of the study was from the National Health System point of view, using a time horizon of 5 years and patient lifetime. All costs were expressed in 2009 euros and a 3% discount rate was applied.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The cost (only pharmacologic costs) per quality-adjusted life year (QALY) gained with Metoject<span class="elsevierStyleSup">®</span> went from 25,173 to 35,807 € at 5 years and from 19,056 to 25,351 € for patient lifetime. When direct costs in RA treatment were considered, it was observed that cost-effectiveness at 5 years went from 29,682 to 42,175 €/QALY gained, and for patient lifetime from 22,514 to 29,848 €/QALY gained.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Additional costs of Metoject<span class="elsevierStyleSup">®</span> with respect to oral methotrexate would be offset by their improved effectiveness, expressed in QALY, showing that Metoject<span class="elsevierStyleSup">®</span> could be a cost-effective treatment option for RA in the Spanish Health System assuming a spanish threshold.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio ha sido comparar la eficiencia de utilizar el metotrexato subcutáneo (Metoject<span class="elsevierStyleSup">®</span>) con respecto al metotrexato oral en el manejo de pacientes con AR en España.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un análisis coste-efectividad/utilidad del tratamiento de la AR temprana utilizando un modelo de Markov. El modelo ha permitido estimar la efectividad a largo plazo del tratamiento de la AR en función de los datos de la literatura y de la opinión de expertos y combinarlo con información de los costes en España. El análisis se ha realizado desde la perspectiva del Sistema Nacional de Salud, utilizando un horizonte temporal de 5 años y de toda la vida del paciente. Todos los costes se expresaron en euros del año 2009 y se ha utilizado una tasa de descuento del 3%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La razón de coste (sólo costes farmacológicos) por año de vida ajustado por calidad (AVAC) ganado con Metoject<span class="elsevierStyleSup">®</span> fue de 25.173–35.807 € a los 5 años y de 19.056–25.351 € para toda la vida. Al tener en cuenta los costes directos de la AR se observó que el coste-efectividad a los 5 años fue de 29.682–42.175 €/AVAC ganado y para toda la vida fue de 22.514–29.848 €/AVAC ganado.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los costes adicionales de Metoject<span class="elsevierStyleSup">®</span> respecto a metotrexato oral se verían compensados por su mejora en efectividad, expresada en términos de AVAC, revelando que Metoject<span class="elsevierStyleSup">®</span> podría ser un tratamiento costeefectivo para la AR en el Sistema Nacional de Salud según el umbral asumido en España.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| 2024 October | 34 | 46 | 80 |
| 2024 September | 35 | 23 | 58 |
| 2024 August | 40 | 42 | 82 |
| 2024 July | 40 | 46 | 86 |
| 2024 June | 31 | 30 | 61 |
| 2024 May | 40 | 40 | 80 |
| 2024 April | 30 | 20 | 50 |
| 2024 March | 34 | 38 | 72 |
| 2024 February | 32 | 27 | 59 |
| 2024 January | 21 | 24 | 45 |
| 2023 December | 18 | 30 | 48 |
| 2023 November | 19 | 24 | 43 |
| 2023 October | 33 | 29 | 62 |
| 2023 September | 30 | 35 | 65 |
| 2023 August | 19 | 16 | 35 |
| 2023 July | 24 | 26 | 50 |
| 2023 June | 22 | 24 | 46 |
| 2023 May | 18 | 14 | 32 |
| 2023 April | 19 | 9 | 28 |
| 2023 March | 31 | 38 | 69 |
| 2023 February | 19 | 39 | 58 |
| 2023 January | 19 | 31 | 50 |
| 2022 December | 29 | 51 | 80 |
| 2022 November | 24 | 36 | 60 |
| 2022 October | 25 | 24 | 49 |
| 2022 September | 23 | 36 | 59 |
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| 2022 July | 22 | 50 | 72 |
| 2022 June | 25 | 47 | 72 |
| 2022 May | 22 | 50 | 72 |
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| 2022 February | 13 | 39 | 52 |
| 2022 January | 21 | 57 | 78 |
| 2021 December | 25 | 59 | 84 |
| 2021 November | 28 | 51 | 79 |
| 2021 October | 26 | 58 | 84 |
| 2021 September | 26 | 44 | 70 |
| 2021 August | 28 | 51 | 79 |
| 2021 July | 16 | 30 | 46 |
| 2021 June | 25 | 38 | 63 |
| 2021 May | 23 | 44 | 67 |
| 2021 April | 43 | 92 | 135 |
| 2021 March | 54 | 35 | 89 |
| 2021 February | 26 | 31 | 57 |
| 2021 January | 24 | 25 | 49 |
| 2020 December | 24 | 17 | 41 |
| 2020 November | 24 | 20 | 44 |
| 2020 October | 17 | 13 | 30 |
| 2020 September | 24 | 31 | 55 |
| 2020 August | 17 | 29 | 46 |
| 2020 July | 16 | 19 | 35 |
| 2020 June | 25 | 28 | 53 |
| 2020 May | 20 | 13 | 33 |
| 2020 April | 27 | 10 | 37 |
| 2020 March | 16 | 10 | 26 |
| 2020 February | 2 | 0 | 2 |
| 2020 January | 4 | 0 | 4 |
| 2019 September | 4 | 0 | 4 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 May | 3 | 1 | 4 |
| 2018 April | 26 | 9 | 35 |
| 2018 March | 35 | 16 | 51 |
| 2018 February | 17 | 8 | 25 |
| 2018 January | 26 | 7 | 33 |
| 2017 December | 24 | 10 | 34 |
| 2017 November | 26 | 5 | 31 |
| 2017 October | 31 | 13 | 44 |
| 2017 September | 11 | 5 | 16 |
| 2017 August | 13 | 9 | 22 |
| 2017 July | 18 | 13 | 31 |
| 2017 June | 21 | 11 | 32 |
| 2017 May | 19 | 14 | 33 |
| 2017 April | 11 | 10 | 21 |
| 2017 March | 10 | 9 | 19 |
| 2017 February | 9 | 11 | 20 |
| 2017 January | 10 | 11 | 21 |
| 2016 December | 32 | 22 | 54 |
| 2016 November | 17 | 1 | 18 |
| 2016 October | 23 | 7 | 30 |
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| 2016 August | 18 | 3 | 21 |
| 2016 July | 17 | 6 | 23 |
| 2016 June | 1 | 8 | 9 |
| 2016 May | 0 | 6 | 6 |
| 2016 April | 0 | 9 | 9 |
| 2016 March | 1 | 3 | 4 |
| 2016 February | 2 | 12 | 14 |
| 2016 January | 4 | 7 | 11 |
| 2015 December | 3 | 12 | 15 |
| 2015 November | 4 | 4 | 8 |
| 2015 October | 5 | 12 | 17 |
| 2015 September | 3 | 0 | 3 |
| 2015 August | 2 | 9 | 11 |
| 2015 July | 25 | 4 | 29 |
| 2015 June | 33 | 21 | 54 |
| 2015 May | 52 | 14 | 66 |
| 2015 April | 38 | 32 | 70 |
| 2015 March | 28 | 26 | 54 |
| 2015 February | 42 | 17 | 59 |
| 2015 January | 43 | 15 | 58 |
| 2014 December | 44 | 22 | 66 |
| 2014 November | 21 | 20 | 41 |
| 2014 October | 27 | 20 | 47 |
| 2014 September | 36 | 19 | 55 |
| 2014 August | 29 | 19 | 48 |
| 2014 July | 28 | 28 | 56 |
| 2014 June | 47 | 20 | 67 |
| 2014 May | 60 | 27 | 87 |
| 2014 April | 49 | 16 | 65 |
| 2014 March | 47 | 25 | 72 |
| 2014 February | 32 | 26 | 58 |
| 2014 January | 33 | 20 | 53 |
| 2013 December | 26 | 20 | 46 |
| 2013 November | 25 | 24 | 49 |
| 2013 October | 26 | 20 | 46 |
| 2013 September | 29 | 34 | 63 |
| 2013 August | 35 | 24 | 59 |
| 2013 July | 20 | 25 | 45 |
| 2013 June | 35 | 23 | 58 |
| 2013 May | 26 | 34 | 60 |
| 2013 April | 16 | 22 | 38 |
| 2013 March | 30 | 18 | 48 |
| 2013 February | 20 | 32 | 52 |
| 2013 January | 15 | 22 | 37 |
| 2012 December | 23 | 21 | 44 |
| 2012 November | 8 | 21 | 29 |
| 2012 October | 5 | 11 | 16 |
| 2012 September | 7 | 3 | 10 |
| 2012 June | 3 | 0 | 3 |
| 2012 April | 5 | 0 | 5 |
| 2012 March | 4 | 0 | 4 |
| 2012 February | 2 | 0 | 2 |
| 2012 January | 2 | 0 | 2 |
| 2011 December | 3 | 0 | 3 |
| 2011 November | 5 | 0 | 5 |
| 2011 October | 4 | 0 | 4 |
| 2011 September | 2 | 0 | 2 |
| 2011 August | 2 | 0 | 2 |
| 2011 June | 2 | 0 | 2 |
| 2011 May | 3 | 0 | 3 |
| 2011 April | 2 | 0 | 2 |
| 2011 March | 4 | 0 | 4 |
| 2011 February | 8 | 0 | 8 |
| 2011 January | 10 | 0 | 10 |
| 2010 December | 4 | 0 | 4 |
| 2010 November | 14 | 0 | 14 |
| 2010 October | 11 | 0 | 11 |
Show all
