Cost-Effectiveness Analysis of Tofacitinib for the Treatment of Moderate to Severe Rheumatoid Arthritis: A Systematic Review and Meta-Analysis Publisher Pubmed



Fatemi B¹ ; Yaghoubi N² ; Shobeiri N³ ; Ahmadi R² ; Mousavi T^{4, 5} ; Soleymani F^{1, 6} ; Rezaei S² Show Affiliations
Source: Expert Review of Pharmacoeconomics and Outcomes Research Published:2025

Abstract

Background: As rheumatoid arthritis (RA) is a chronic and progressive disease that requires lifelong therapeutic intervention, it represents a considerable economic burden on those affected. This study investigated whether tofacitinib is a cost-effective therapeutic alternative to other DMARDs for treating moderate-to-severe RA. Research Design and Methods: All economic evaluation studies of tofacitinib compared to other DMARDs were identified. Using random-effects meta-analysis, we pooled incremental net benefit (INB) in (purchasing power parity) adjusted US$ with 95% confidence intervals. The modified economic evaluation bias checklist and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) instrument for quality appraisal were used. The subgroup analysis was done based on the comparator regimen. Results: Of the selected 11 studies, the number of studies from high-, upper-middle- and lower-middle-income countries was 7, 3, and 1, respectively. The subgroup analysis showed that tofacitinib with an INB of 19,180 US$ [95% CI, −34520 to −3840; p-value = 0.01] was not statistically cost-effective compared with cDMARDs (p-value > 0.0001). Compared to other DMARDs, the estimated pooled INB of tofacitinib was US$ 7260 [95% CI, 3030 to 11,480; p-value < 0.001], but there was substantial heterogeneity among the included studies, and the observed publication bias Conclusion: While tofacitinib shows potential as a cost-effective treatment, tailored economic evaluations are needed to account for the diverse and evolving contexts of RA treatment. Registration: PROSPERO: CRD42023405970. © 2024 Informa UK Limited, trading as Taylor & Francis Group.