Análisis y evaluación del coste del tratamiento anti-TNFalfa en artritis reumatoide y espondilitis anquilosante. Dosis individualizadas frente a comercializadas.

Objective: to assess the cost of different biological therapies through the analysis of the theoretical and actual annual costs in routine clinical practice. Materials and method: retrospective observational study in patients with rheumatoid arthritis (RA) or spondylitis (AS) who initiated treatment with any of the available anti-TNF-alfa may of 2013 to September 2015. The average annual cost per patient depending on the treatment and pathology analyzed. Results: 94 pharmaceutical records of patients with rheumatologic disease diagnosed were analyzed [49 (52.1%)] AR and 45 (47.9%) EA]. Treatment received during the period of study: patients with RA (49.0% adalimumab, 44.9% etanercept, 6.1% infliximab); patients with AD (44.4% adalimumab, 37.8% etanercept, 17.8% infliximab). The average annual cost per patient was €12.009,3. There were no differences in annual costs among the different treatments for RA [(11.977,8 € adalimumab, 11.015,2 € etanercept, 10.717,8 € infliximab; p>0,05), while in the case of the EA etanercept turned out to be the lowest cost treatment [(12.231,49 € adalimumab, 12.088,2 € etanercept, 14.598,7 € infliximab; p<0.05).]] Conclusions: the choice of etanercept appears to contribute to lower pharmaceutical spending in our environment. Would be necessary an optimization in the management of our patients to achieve a better adjustment of doses that allowed optimize the expenditure pharmaceutical