© 2005 by BMJ Publishing Group Ltd & European League Against Rheumatism
LEADER
Anti-tumour necrosis factor 
Anti-tumour necrosis factor
therapy: can we afford it?
Correspondence to:
Correspondence to:
Professor D P M Symmons
ARC Epidemiology Unit, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PT, UK; deborah.symmons@man.ac.uk
Cost is now a factor in selecting treatment
Keywords: rheumatoid arthritis; modelling; cost effectiveness; cost utility analysis; tumour necrosis factor
; adalimumab
| The first 150 words of the full text of this article appear below. |
The introduction of biological agents into the therapeutic armamentarium for rheumatoid arthritis (RA) has ushered in a new era for rheumatologists in more ways than one. Randomised controlled trials (RCTs) and longitudinal observational studies provide clear evidence that the use of these agents is associated with a greater proportion of responders and a better response than with conventional disease modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX).19 However, these drugs are substantially more expensive than conventional DMARDs. This means that, whether we like it or not (and most of us dont like it), cost is now one of the factors we have to consider when selecting treatment for patients with RA. Perhaps for the first time rheumatologists are having to take part in the process of healthcare policy making and endeavour to understand the language of cost effectiveness analysis (CEA). CEA compares the incremental cost of an
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