| Summary: | It is estimated that 20,000-30,000 people in Norway suffer from the disease. Due to the patients' reduced functional capacity, costs are incurred by employers, relatives and not least the patients themselves. Research has shown that early treatment with biologic drugs may be beneficial. Biologics are however more costly than conventional DMARDs, and Norwegian guidelines therefore stipulate that at least one DMARD should be attempted before treatment with biologic drugs is initiated. The Norwegian Knowledge Centre for the Health Services has reviewed the literature on the cost-effectiveness of biologic treatment for early RA as part of a project commissioned by the commissioned by the Norwegian Rheumatism Association. We searched systematically for health economic evaluations of biologic treatment of patients with early RA (disease duration of three years or less) compared with DMARD treatment. We found six studies, which all incorporated a TNF-inhibitor such as aldalimumab, etanercept or infliximab. No studies on the other biologic drugs were found. Our findings were:1. Treatment with biologic drugs in early RA may be cost-effective, though not necessarily as first-line treatment.2. This is consistent with current Norwegian guidelines which state that treatment with at least one DMARD should be attempted before biologic treatment is initiated.3. Inclusion of indirect costs has a major bearing on the results.4. The study results vary significantly
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