Cost-effectiveness of Anbainuo Plus Methotrexate Compared to Conventional Disease-modifying Antirheumatic Drugs for Rheumatoid Arthritis Patients in China

Background: This study aimed to evaluate the cost-effectiveness of anbainuo (ABN) plus methotrexate (MTX) versus conventional disease-modifying antirheumatic drugs (cDMARDs) in Chinese rheumatoid arthritis (RA) patients. Methods: : Ninety RA patients who underwent ABN+MTX (assigned as ABN+MTX group (N=47)) or cDMARDs (assigned as control group (N=43)) treatment were analyzed. Disease activity was assessed at baseline (M0), 3 rd month (M3), 6 th month (M6) and 12 th month (M12) after treatment. Drug, other medical, indirect and total costs were calculated. Then pharmacoeconomic analyses were performed with the threshold of cost-effectiveness set as 3 times of the mean gross domestic product per capita in China during the study period. Results: : Treatment response rate was similar, while disease remission and low disease activity rates were increased in ABN+MTX group compared to control group. Drug cost, other medical cost and total cost were higher in ABN+MTX group than control group, while indirect cost was similar between the two groups. Meanwhile, the quality-adjusted life years (QALY) in ABN+MTX group and control group were 0.72 and 0.48 years, respectively. The incremental cost-effectiveness ratios (ICER) of ABN+MTX group compared to control group in total patients, moderate-disease-activity patients and severe-disease-activity patients were ¥135486.7, ¥146450.4 and ¥124987.2/QALY, respectively, which were all below cost-effectiveness threshold. Further sensitivity analyses revealed that the cost-effectiveness of ABN+MTX versus cDMARDs was relative robust, while among all the indexes, ABN price and HAQ-DI score change for ABN+MTX group affected ICER most. Conclusions: : ABN+MTX treatment presents acceptable cost-effectiveness compared to cDMARDs treatment in Chinese RA patients.