Tocilizumab More Cost-Effective at Treating Patients With RA Than Abatacept

In a study designed to identify the relevant cost per number needed to treat (NNT) for the 2 biological disease-modifying antirheumatic drugs tocilizumab (TCZ) and abatacept (ABT), researchers determined that TCZ had a higher efficacy. The results were published in ClinicoEconomics and Outcomes Research.

The authors used clinical data from a Technology Appraisal Guidance published by the National Institute for Health and Care Excellence in January 2016 to estimate the efficacy and treatment costs associated with the use of TCZ plus methotrexate (Mtx) versus ABT plus Mtx when treating patients with rheumatoid arthritis (RA) who were previously treated with Mtx.

In this study, the NNT “represents the number of patients who needed to be treated with TCZ plus Mtx or with ABT plus Mtx” compared with conventional disease-modifying antirheumatic drugs, such as Mtx alone, “to obtain a positive patient response.” Efficacy was measured based on response criteria from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR).

Both ABT and TCZ can be administered subcutaneously (sc) or intravenously (iv). The research found that the lost cost of treatment was ABT (sc) plus Mtx (€6398.98 or $7450.01) and the highest cost of treatment was ABT (iv) plus Mtx (€7342.66 or $8549.61).

The researchers found that when they calculated mean cost per NNT using ACR response criteria that TCZ (sc) had the lowest cost per NNT. Interestingly, TCZ (iv) may have had higher costs of administration and monitoring but it had lower mean costs per NNT compared to both forms of ABT. Using EULAR criteria also found TCZ (sc) to be the best therapeutic followed by TCZ (iv).

Based on their findings, the authors determined that TCZ, in both forms, is a more cost-effective option than both forms of ABT when it comes to treating patients with RA who were previously treated with Mtx.

“The findings of this study should encourage the undertaking of future clinical observational and real-world studies aimed at promoting a more efficient use of biological therapies in the treatment of RA,” the authors concluded.