CADTH Review Panel releases recommendations for Biologic Response Modifier Agents for Adults with RA

The Canadian Agency for Drugs and Technologies in Health's (CADTH) Therapeutic Review Panel released last week their recommendations for Biologic Response Modifier Agents for Adults with Rheumatoid Arthritis (RA).

The Canadian Agency for Drugs and Technologies in Health is an impartial third party organization funded by federal, provincial, and territorial governments. The purpose of this report, which was commissioned by government, is to give evidence-based information about the effectiveness of drugs to health care decision makers. This Biologics class review in RA, which is the first of its kind in Canada, found HUMIRA to be the most cost effective anti-TNF due to duration of efficacy,

The report highlights two key recommendations: for patients with inadequate response on optimal doses of disease-modifying antirheumatic drugs (DMARDs), a biologic could be used in combination with methotrexate (MTX) or other DMARDs, and if there is no response or a loss of response, the dose of the biologic should not be increased beyond the lowest approved dose by Health Canada.

The focus of this review was the relative cost-effectiveness of biologics in patients who failed treatment with traditional DMARDs such as MTX. The time horizon of the economic model was five years with a cycle length of three months. The primary outcome in the economic analysis was the time with an American College of Rheumatology (ACR) 50 response, which was based on ACR responses and withdrawal rates from the CADTH mixed treatment comparison (MTC) meta-analysis. ARC 50 response is the most rigorous way of assessing how a disease is controlled.

"Based on the CADTH report, HUMIRA was shown to be the most cost effective anti-TNF since it had the longest time with an ACR 50 response at the lowest cost," states Jeff Devlin, General Manager of Abbott International, Canada says: "We commend CADTH for this thorough class review. CADTH is an unbiased source validating HUMIRA's proven efficacy, sustainability, and value to the rheumatology community."

The recommendations were formulated following a comprehensive evidence-based review of the medication's efficacy or effectiveness and safety and an assessment of its cost-effectiveness. The final recommendations along with the clinical and economic overview report are available on CADTH's Web site.