The British Journal of Rheumatology, Vol 37, 1102-1109, Copyright © 1998 by British Society for Rheumatology
AC Verhoeven, JC Bibo, M Boers, GL Engel and S van der Linden
OBJECTIVE: Assessment of the cost-effectiveness and cost-utility of early
intervention in rheumatoid arthritis (RA) patients, with combined step-down
prednisolone, methotrexate and sulphasalazine, compared to sulphasalazine
alone. METHODS: Multicentre 56 week randomized double- blind trial with
full economic analysis of direct costs and utility analysis with rating
scale and standard gamble measurement techniques. RESULTS: The
combined-treatment group included 76 patients and the sulphasalazine group
78 patients. The mean total costs per patient in the first 56 weeks of
follow-up were $5519 for combined treatment and $6511 for treatment with
sulphasalazine alone (P = 0.37). Out-patient care, in-patient care and
non-health care each contributed about one- third to the total costs. The
combined-treatment group appeared to generate savings in the length of
hospital stay for RA, non-protocol drugs and costs of home help, but
comparisons were not statistically significant. Protocol drugs and
monitoring were slightly more expensive in the combined-treatment group.
Clinical, radiographic and functional outcomes significantly favoured
combined treatment at week 28 (radiography also at week 56). Utility scores
also favoured combined treatment. CONCLUSION: Combined treatment is
cost-effective due to enhanced efficacy at lower or equal direct costs.
ORIGINAL PAPERS
Cost-effectiveness and cost-utility of combination therapy in early rheumatoid arthritis: randomized comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone. COBRA Trial Group. Combinatietherapie Bij Reumatoide Artritis
Department of Internal Medicine and Rheumatology, Maastricht University Hospital, The Netherlands.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. H. D. van Tuyl, A. M. C. Plass, W. F. Lems, A. E. Voskuyl, P. J. S. M. Kerstens, B. A. C. Dijkmans, and M. Boers Discordant perspectives of rheumatologists and patients on COBRA combination therapy in rheumatoid arthritis Rheumatology, August 18, 2008; (2008) ken323v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. H D van Tuyl, A. M. C Plass, W. F Lems, A. E Voskuyl, B. A C Dijkmans, and M. Boers Why are Dutch rheumatologists reluctant to use the COBRA treatment strategy in early rheumatoid arthritis? Ann Rheum Dis, July 1, 2007; 66(7): 974 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brennan, N. Bansback, A. Reynolds, and P. Conway Modelling the cost-effectiveness of etanercept in adults with rheumatoid arthritis in the UK Rheumatology, January 1, 2004; 43(1): 62 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Boonen, D van der Heijde, R Landewe, F Guillemin, M Rutten-van Molken, M Dougados, H Mielants, K de Vlam, H van der Tempel, S Boesen, et al. Direct costs of ankylosing spondylitis and its determinants: an analysis among three European countries Ann Rheum Dis, August 1, 2003; 62(8): 732 - 740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S E Gabriel, P Tugwell, and M Drummond Progress towards an OMERACT-ILAR guideline for economic evaluations in rheumatology Ann Rheum Dis, April 1, 2002; 61(4): 370 - 373. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Quinn, P. G. Conaghan, and P. Emery The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence? Rheumatology, November 1, 2001; 40(11): 1211 - 1220. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Lambert Medical therapy for rheumatoid arthritis--value for money? Rheumatology, September 1, 2001; 40(9): 961 - 964. [Full Text] [PDF]
|
|
|
|
|
|
A C Verhoeven, M Boers, and S van der Linden Responsiveness of the core set, response criteria, and utilities in early rheumatoid arthritis Ann Rheum Dis, December 1, 2000; 59(12): 966 - 974. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. S. El-Gabalawy, P. Duray, and R. Goldbach-Mansky Evaluating Patients With Arthritis of Recent Onset: Studies in Pathogenesis and Prognosis JAMA, November 8, 2000; 284(18): 2368 - 2373. [Abstract] [Full Text] [PDF]
|
|