This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database.

"The objectives of this review were to assess the comparative clinical effectiveness and cost-effectiveness of adalimumab, etanercept and infliximab for the treatment of AS. The following comparisons are made: adalimumab and conventional management versus conventional management etanercept and conventional management versus conventional management infliximab and conventional management versus conventional management between adalimumab, etanercept and infliximab, where data are available."

(from executive summary)

The review of clinical data related to the three drugs (including conventional treatment) compared with conventional treatment plus placebo indicates that in the short term (12;24 weeks) the three treatments demonstrate clinical and statistical effectiveness in relation to assessment of ASAS, BASDAI and BASFI. Indirect comparisons of treatments were limited and were not able to determine a significant difference in effectiveness between the three agents.

The short-term economic assessment indicates that none of the three anti-TNF-a agents is likely to be considered cost-effective at current acceptability thresholds, with infliximab consistently the least favourable option. Analyses carried out by the assessment group over the longer term challenge the assumptions made in the company submissions that costs will decrease over time. Owing to these large and sustained costs, the impact on the NHS budget is likely to be considerable.

http://www.inahta.org/Publications/Briefs-Checklist-Impact/20072/3140/