Determination of clinical outcome and pharmacoeconomics of anti–rheumatoid arthritis therapy using CDAI, EQ–5D–3L and EQ–VAS as indices of disease amelioration

ObjectiveArthritis is a severe debilitating chronic disease. The objective of the present investigation was to evaluate the clinical outcome and cost effectiveness of anti–rheumatoid arthritis regimen for the treatment of arthritis.MethodsThe patients were classified into three treatment cohorts on the basis of the treatment regimens prescribed by the physicians. These were group I consisting of patients treated with monotherapy of non-steroidal anti– inflammatory drugs alone, group II consisting of patients treated with disease modifying anti rheumatoid drugs + non-steroidal anti– inflammatory drugs and group III consisting of patients treated with disease modifying anti rheumatoid drugs along with oral Corticosteroids. The patient reported outcome was measured using European questionnaire 5 dimension 3 levels (EQ–5D–3L) and European questionnaire visual analogue scale (EQ–VAS) before and after the treatment regimen. Clinical outcome was measured using Clinical disease activity index (CDAI). The details of costs were recorded by interviewing the patients.ResultsThe patient reported outcome measured by EQ–5D–3L and EQ–VAS was significantly improved in patients belonging to group III when compared to group II (P < 0.05) and I (P < 0.001) respectively. The outcomes of CDAI scores demonstrate that the mean change in CDAI levels was 7.04, 12.01 and 16.98 in group I, II and III respectively. Total cost incurred per patient was found to be equal to Rs. 1120 ($19.6) in group I, Rs. 1685 ($29.49) in group II and Rs. 2465 ($43.14) in group III. The ACER was determined as 159.09 in group I, 140.299 in group II and 145.17 in group III.ConclusionAmelioration of arthritis in clinics can be effectively measured by validated instruments (EQ–5D–3L, EQ–VAS, CDAI) and DMARDs along with NSAIDs are the most cost effective therapy for treatment of arthritis.