The superb efficacy of ABN was mainly due to that: ABN is a recombinant human TNF-II:Fc fusion protein which is able to inhibit dysregulated activity of TNF- directly in RA patients through acting like a decoy TNF receptor, whereas cDMARDs inhibit dysregulated activity of TNF- through regulating activities of immune cells, which is less effective compared with ABN; therefore, ABN decreases disease activity of RA individuals more obviously than that of cDMARDs, and more obvious disease activity decrement means more alleviated symptoms and higher QoL improvement. by 20% produced an ICER of 130,403.6 per QALY, which was still lower than 3 times of the mean gross domestic product (GDP) per capita during the same period in China (165,960). Besides, ABN?+?MTX was more cost-effective in severe RA VU 0364439 individuals compared to moderate RA individuals. ABN?+?MTX is cost-effective in treating moderate to severe RA individuals compared with cDMARDs, although the total cost of ABN?+?MTX is relatively higher. test or Chi-square test; comparison at combined time point was determined by paired test. All tests were 2-sided and test. em P /em ? ?.05 was considered significant. ? em P /em ? ?.05, ?? em P /em ? ?.01. DAS28 = disease activity score in 28 bones, ESR?=?erythrocyte sedimentation rate, CRP?=?C-reactive protein, TJC?=?tender Joint Count, SJC?=?inflamed VU 0364439 Joint Count, VAS?=?Visual Analogue Scale, ABN?=?Anbainuo, MTX?=?methotrexate, PGA?=?individual global assessment, PhGA?=?physician global assessment, HAQ-DI?=?Health Assessment Questionnaire Disability Index. 3.4. Assessment of DAS28-ESR response rate, remission rate and LDA rate between two organizations No difference of DAS28-ESR response rate was found out between ABN?+?MTX group and control group at M6 ( em P /em ?=?.516) or M12 ( em P /em ?=?0.221) (Fig. ?(Fig.3A);3A); in addition, DAS28-ESR remission rate ( em P /em ?=?.055, Fig. ?Fig.3B)3B) and DASS28-ESR LDA rate ( em P /em ?=?.977, Fig. ?Fig.3C)3C) were also related between 2 organizations at M6, whereas both of them were obviously increased in ABN?+?MTX group compared with control group at M12 (all em P /em ? ?.05), which further implied that ABN?+?MTX presented with better treatment efficacy compared with cDMARDs. Open in a separate window Number 3 DAS28-ESR response rate, remission rate and LDA rate between 2 organizations. No difference of DAS28-ESR response rate was found between ABN?+?MTX group and control group at M6 VU 0364439 or M12 (A), DAS28-ESR remission rate (B) and DASS28-ESR LDA rate (C) were also related between two organizations at M6, while both of them were increased in ABN?+?MTX group compared with control group at M12. Assessment between two organizations was determined by Chi-square test. em P /em ? ?.05 was considered significant, which were shown as bold. DAS28 = disease activity score in 28 bones; ESR?=?erythrocyte sedimentation rate, ABN?=?Anbainuo, MTX?=?methotrexate, LDA?=?low disease activity. 3.5. Assessment of cost between ABN?+?MTX group and control group Drug cost, additional medical cost, indirect cost and total cost of RA individuals at M6 and M12 were compared between ABN?+?MTX group and control group, which revealed that (Table ?(Table22): Table 2 Comparison of cost between 2 organizations. Open in a separate windows (1) at M6, drug cost (27,970.5??1,116.5 vs 3,723.6??2,023.6, em P /em ? ?.001) and total cost (45,482.0??15,294.3 vs 21,595.6??2,678.6, em P /em ? ?.001) were elevated in ABN?+?MTX group compared with control group; (2) at M12, drug cost (39,433.9??20,301.7 vs 7126.6??4022.0, em P /em ? ?.001) and total cost (58,208.2??23,433.9 vs 35,263.6??4150.2, em P /em ? ?.001) were increased whereas indirect cost (8389.0??10,511.8 vs 14,952.0??1779.2, em P /em ?=?.004) was decreased in ABN?+?MTX group compared to control group; (3) as for additional medical cost, no difference was found out EIF4EBP1 between 2 organizations either at M6 (9,893.1??9,462.8 vs 9,188.6??1,521.3, em P /em ?=?.711) or at M12 (10,385.4??9,393.6 vs 13,185.0??1644.0, em P /em ?=?.147). These data suggested that ABN?+?MTX decreased indirect cost while increased drug cost and total cost compared with cDMARDs. 3.6. Cost-effectiveness of ABN?+?MTX vs cDMARDs in RA individuals Individuals in ABN?+?MTX group and control group achieved 0.66 QALY and 0.44 QALY at M12 respectively, thus ABN?+?MTX group gained additional 0.22 QALY compared to VU 0364439 control group; on the other hand, ABN?+?MTX group cost extra 22,944.6 compared with control group; resulting in an ICER of 104,293.6 per QALY, which was lower than 2 times of the mean GDP per capita during the same period in China. Consequently, ABN?+?MTX was cost-effective in increasing the QALY of RA individuals (Table ?(Table33). Table 3 Cost-effectiveness analysis. Open in a separate windows 3.7. Cost-effectiveness of ABN?+?MTX vs cDMARDs in subgroups RA individuals were further divided into moderate RA individuals and severe RA individuals according to disease activity (criteria were depicted in Method Section), then cost-effectiveness analysis was conducted respectively (Table ?(Table4).4). In moderate RA individuals, ABN?+?MTX group yielded 0.69 QALY at M12 while control group yielded 0.44 QALY at the same time, thus ABN?+?MTX group gained additional 0.25 QALY compared with control group; besides, ABN?+?MTX group cost additional 27,052.6 compared with control group, leading to an ICER of 108,210.4 per QALY in moderate RA individuals. In severe RA individuals, QALY was 0.66 and 0.45 in ABN?+?MTX group and control group, ABN?+?MTX group achieved extra 0.21 QALY accordingly, and ABN?+?MTX group cost more 22,053.7 than that of control group, resulting an ICER of 105,017.6 per QALY in severe RA individuals (Table ?(Table4).4). Both the abovementioned ICERs were below 2 times of the imply GDP per capita during the same period in China..