{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:28Z","timestamp":1792787788744,"version":"4.5.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T00:00:00Z","timestamp":1702684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T00:00:00Z","timestamp":1702684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Pfizer Hellas"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Drug Investig"],"published-print":{"date-parts":[[2024,1]]},"DOI":"10.1007\/s40261-023-01333-z","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T19:01:36Z","timestamp":1702753296000},"page":"59-69","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cost Effectiveness of Tofacitinib for the Treatment of Active Ankylosing Spondylitis in Greece"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-9829","authenticated-orcid":false,"given":"George","family":"Gourzoulidis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argyro","family":"Solakidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Psarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Nikitopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalampos","family":"Tzanetakos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,16]]},"reference":[{"key":"1333_CR1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/s41413-019-0057-8","volume":"7","author":"W Zhu","year":"2019","unstructured":"Zhu W, He X, Cheng K, et al. Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone Res. 2019;7:22.","journal-title":"Bone Res."},{"issue":"4","key":"1333_CR2","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1002\/art.11197","volume":"49","author":"R Ariza-Ariza","year":"2003","unstructured":"Ariza-Ariza R, Hern\u00e1ndez-Cruz B, Navarro-Sarabia F. Physical function and health-related quality of life of Spanish patients with ankylosing spondylitis. Arthritis Rheum. 2003;49(4):483\u20137.","journal-title":"Arthritis Rheum"},{"key":"1333_CR3","first-page":"4","volume":"78","author":"A Boonen","year":"2006","unstructured":"Boonen A, van der Linden SM. The burden of ankylosing spondylitis. J Rheumatol Suppl. 2006;78:4\u201311.","journal-title":"J Rheumatol Suppl"},{"issue":"4","key":"1333_CR4","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1002\/1529-0131(199908)12:4<247::AID-ART3>3.0.CO;2-H","volume":"12","author":"MM Ward","year":"1999","unstructured":"Ward MM. Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res. 1999;12(4):247\u201355.","journal-title":"Arthritis Care Res"},{"issue":"7","key":"1333_CR5","first-page":"1589","volume":"30","author":"A Andrianakos","year":"2003","unstructured":"Andrianakos A, Trontzas P, Christoyannis F, et al. Prevalence of rheumatic diseases in Greece: a cross-sectional population based epidemiological study. The ESORDIG Study. J Rheumatol. 2003;30(7):1589\u2013601.","journal-title":"J Rheumatol"},{"key":"1333_CR6","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/1471-2474-11-98","volume":"11","author":"I Anagnostopoulos","year":"2010","unstructured":"Anagnostopoulos I, Zinzaras E, Alexiou I, et al. The prevalence of rheumatic diseases in central Greece: a population survey. BMC Musculoskelet Disord. 2010;11:98.","journal-title":"BMC Musculoskelet Disord"},{"issue":"3","key":"1333_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2020-001303","volume":"6","author":"VK Bournia","year":"2020","unstructured":"Bournia VK, Tektonidou MG, Vassilopoulos D, et al. Introduction and switching of biologic agents are associated with antidepressant and anxiolytic medication use: data on 42 815 real-world patients with inflammatory rheumatic disease. RMD Open. 2020;6(3): e001303.","journal-title":"RMD Open"},{"issue":"1","key":"1333_CR8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1136\/ard-2022-223296","volume":"82","author":"S Ramiro","year":"2023","unstructured":"Ramiro S, Nikiphorou E, Sepriano A, et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023;82(1):19\u201334.","journal-title":"Ann Rheum Dis"},{"key":"1333_CR9","unstructured":"Ministry of Health. Greek therapeutic protocol for axial spondyloarthritis. 2018. https:\/\/www.moh.gov.gr\/articles\/health\/domes-kai-draseis-gia-thn-ygeia\/kwdikopoihseis\/therapeytika-prwtokolla-syntagografhshs\/diagnwstika-kai-therapeytika-prwtokolla-syntagografhshs\/5627-diagnwstika-kai-therapeytika-prwtokolla-syntagografhshs-reymatologikwn-noshmatwn. Accessed 7 Jul 2022."},{"key":"1333_CR10","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s41927-020-0118-z","volume":"4","author":"A Deodhar","year":"2020","unstructured":"Deodhar A, Strand V, Conaghan PG, et al. Unmet needs in ankylosing spondylitis patients receiving tumour necrosis factor inhibitor therapy; results from a large multinational real-world study. BMC Rheumatol. 2020;4:19.","journal-title":"BMC Rheumatol."},{"issue":"2","key":"1333_CR11","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2017-000524","volume":"3","author":"V Navarro-Comp\u00e1n","year":"2017","unstructured":"Navarro-Comp\u00e1n V, Plasencia-Rodr\u00edguez C, de Miguel E, Diaz Del Campo P, Balsa A, Gratac\u00f3s J. Switching biological disease-modifying antirheumatic drugs in patients with axial spondyloarthritis: results from a systematic literature review. RMD Open. 2017;3(2): e000524.","journal-title":"RMD Open"},{"issue":"10","key":"1333_CR12","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1093\/rheumatology\/ket249","volume":"52","author":"A Spadaro","year":"2013","unstructured":"Spadaro A, Lubrano E, Marchesoni A, et al. Remission in ankylosing spondylitis treated with anti-TNF-\u03b1 drugs: a national multicentre study. Rheumatology (Oxford). 2013;52(10):1914\u20139.","journal-title":"Rheumatology (Oxford)"},{"issue":"2","key":"1333_CR13","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s40744-019-0148-4","volume":"6","author":"T Hunter","year":"2019","unstructured":"Hunter T, Schroeder K, Sandoval D, Deodhar A. Persistence, discontinuation, and switching patterns of newly initiated TNF inhibitor therapy in ankylosing spondylitis patients in the United States. Rheumatol Ther. 2019;6(2):207\u201315.","journal-title":"Rheumatol Ther."},{"issue":"Suppl._6","key":"1333_CR14","first-page":"vi3","volume":"57","author":"H Tahir","year":"2018","unstructured":"Tahir H. Therapies in ankylosing spondylitis-from clinical trials to clinical practice. Rheumatology (Oxford). 2018;57(Suppl._6):vi3-8.","journal-title":"Rheumatology (Oxford)"},{"issue":"2","key":"1333_CR15","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1093\/rheumatology\/key070","volume":"58","author":"DJ Veale","year":"2019","unstructured":"Veale DJ, McGonagle D, McInnes IB, et al. The rationale for Janus kinase inhibitors for the treatment of spondyloarthritis. Rheumatology (Oxford). 2019;58(2):197\u2013205.","journal-title":"Rheumatology (Oxford)"},{"issue":"8","key":"1333_CR16","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1136\/annrheumdis-2020-219601","volume":"80","author":"A Deodhar","year":"2021","unstructured":"Deodhar A, Sliwinska-Stanczyk P, Xu H, et al. Tofacitinib for the treatment of ankylosing spondylitis: a phase III, randomised, double-blind, placebo-controlled study. Ann Rheum Dis. 2021;80(8):1004\u201313.","journal-title":"Ann Rheum Dis"},{"issue":"8","key":"1333_CR17","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1136\/annrheumdis-2016-210322","volume":"76","author":"D van der Heijde","year":"2017","unstructured":"van der Heijde D, Deodhar A, Wei JC, et al. Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study. Ann Rheum Dis. 2017;76(8):1340\u20137.","journal-title":"Ann Rheum Dis"},{"issue":"2","key":"1333_CR18","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1080\/14737167.2021.1921576","volume":"22","author":"G Gourzoulidis","year":"2022","unstructured":"Gourzoulidis G, Koulentaki M, Koumarianou A, et al. Cost-effectiveness of trifluridine\/tipiracil as a third-line treatment of metastatic gastric cancer, including adenocarcinoma of the gastrohesophageal junction, among patients previously treated in Greece. Expert Rev Pharmacoecon Outcomes Res. 2022;22(2):259\u201369.","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"1333_CR19","doi-asserted-by":"publisher","first-page":"1229524","DOI":"10.3389\/fpubh.2023.1229524","volume":"11","author":"G Gourzoulidis","year":"2023","unstructured":"Gourzoulidis G, Barmpouni M, Kossyvaki V, Vietri J, Tzanetakos C. Health and economic outcomes of 20-valent pneumococcal conjugate vaccine compared to 15-valent pneumococcal conjugate vaccine strategies for adults in Greece. Front Public Health. 2023;11:1229524.","journal-title":"Front Public Health"},{"issue":"12 Suppl.","key":"1333_CR20","doi-asserted-by":"publisher","first-page":"S74","DOI":"10.1016\/j.jval.2022.09.358","volume":"25","author":"M Koulentaki","year":"2022","unstructured":"Koulentaki M, Tzanetakos C, Stratigos A, et al. EE106 Cost-effectiveness analysis of bimekizumab in patients with moderate-to-severe plaque psoriasis in Greece. Value Health. 2022;25(12 Suppl.):S74.","journal-title":"Value Health."},{"key":"1333_CR21","first-page":"S422","volume":"22","author":"G Gourzoulidis","year":"2019","unstructured":"Gourzoulidis G, Rigopoulos D, Kountouris V, Christou P, Kiri S, Tzanetakos C. PBI28 Cost-effectiveness of certolizumab pegol for the treatment of moderate to severe plaque psoriasis in Greece. Value Health. 2019;22:S422.","journal-title":"Value Health."},{"key":"1333_CR22","doi-asserted-by":"publisher","first-page":"S294","DOI":"10.1016\/j.jval.2018.09.1755","volume":"21","author":"N Kourkoulas","year":"2018","unstructured":"Kourkoulas N, Athanasakis K, Boubouchairopoulou N, Chouchouli K, Kyriopoulos J. PMS41 Cost-effectiveness analysis of tofacitinib in combination with methotrezate in the treatment of moderate to severe rheumatoid arthritis in Greece. Value Health. 2018;21:S294.","journal-title":"Value Health."},{"key":"1333_CR23","doi-asserted-by":"crossref","unstructured":"Tzanetakos C, Solakidi A, Psarra M, Nikitopoulou E, Gourzoulidis G. Economic evaluation of tofacitinib for the treatment of active polyarticular juvenile idiopathic arthritis in Greece. Value Health. 2023;26(11).","DOI":"10.1016\/j.jval.2023.09.463"},{"key":"1333_CR24","doi-asserted-by":"crossref","unstructured":"Tzanetakos C, Kotsis I, Gourzoulidis G. Cost-effectiveness analysis of upadacitinib in patients with active non-radiographic axial spondyloarthritis in Greece. Value Health. 2023;26(11).","DOI":"10.1016\/j.jval.2023.09.531"},{"issue":"9","key":"1333_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta20090","volume":"20","author":"M Corbett","year":"2016","unstructured":"Corbett M, Soares M, Jhuti G, et al. Tumour necrosis factor-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review and economic evaluation. Health Technol Assess. 2016;20(9):1\u2013334 (v\u2013vi).","journal-title":"Health Technol Assess"},{"key":"1333_CR26","unstructured":"National Institute for Health and Care Excellence. Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors. 2016; https:\/\/www.nice.org.uk\/guidance\/ta407. Accessed 7 Jul 2022."},{"issue":"8","key":"1333_CR27","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1007\/s40273-018-0675-9","volume":"36","author":"P Emery","year":"2018","unstructured":"Emery P, Van Keep M, Beard S, et al. Cost Effectiveness of secukinumab for the treatment of active ankylosing spondylitis in the UK. Pharmacoeconomics. 2018;36(8):1015\u201327.","journal-title":"Pharmacoeconomics"},{"issue":"2","key":"1333_CR28","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s40744-017-0083-1","volume":"4","author":"RH Borse","year":"2017","unstructured":"Borse RH, Brown C, Muszbek N, Chaudhary MA, Kachroo S. Cost-effectiveness of golimumab in ankylosing spondylitis from the UK payer perspective. Rheumatol Ther. 2017;4(2):427\u201343.","journal-title":"Rheumatol Ther."},{"issue":"6","key":"1333_CR29","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1136\/ard.2008.091793","volume":"68","author":"R Landew\u00e9","year":"2009","unstructured":"Landew\u00e9 R, Dougados M, Mielants H, van der Tempel H, van der Heijde D. Physical function in ankylosing spondylitis is independently determined by both disease activity and radiographic damage of the spine. Ann Rheum Dis. 2009;68(6):863\u20137.","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"1333_CR30","doi-asserted-by":"publisher","first-page":"2645","DOI":"10.1002\/art.38070","volume":"65","author":"N Haroon","year":"2013","unstructured":"Haroon N, Inman RD, Learch TJ, et al. The impact of tumor necrosis factor \u03b1 inhibitors on radiographic progression in ankylosing spondylitis. Arthritis Rheum. 2013;65(10):2645\u201354.","journal-title":"Arthritis Rheum"},{"key":"1333_CR31","doi-asserted-by":"publisher","unstructured":"Singh JA, Wells GA, Christensen R, et al. Adverse effects of biologics: a network meta\u2010analysis and Cochrane overview. Cochrane Database Syst Rev. 2011;2011(2):CD008794. https:\/\/doi.org\/10.1002\/14651858.CD008794.pub2","DOI":"10.1002\/14651858.CD008794.pub2"},{"issue":"11","key":"1333_CR32","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1136\/ard.2011.151191","volume":"70","author":"G Bakland","year":"2011","unstructured":"Bakland G, Gran JT, Nossent JC. Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis. 2011;70(11):1921\u20135.","journal-title":"Ann Rheum Dis"},{"key":"1333_CR33","unstructured":"World Health Organisation (WHO). Greece life tables. https:\/\/apps.who.int\/gho\/data\/view.main.60640?lang=en. Accessed 1 Jul 2022."},{"key":"1333_CR34","unstructured":"Greek Ministry of Health. Drug price bulletin. 2022. www.moh.gov.gr\/. Accessed 3 Jul 2022."},{"issue":"9","key":"1333_CR35","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1007\/s00296-017-3736-z","volume":"37","author":"C Tzanetakos","year":"2017","unstructured":"Tzanetakos C, Tzioufas A, Goules A, et al. Cost-utility analysis of certolizumab pegol in combination with methotrexate in patients with moderate-to-severe active rheumatoid arthritis in Greece. Rheumatol Int. 2017;37(9):1441\u201352.","journal-title":"Rheumatol Int"},{"key":"1333_CR36","unstructured":"National Organisation for Healthcare Services Provision. EOPYY. 2022. www.eopyy.gov.gr\/Home\/StartPage?a_HomePage=Index. Accessed 20 Jun 2022."},{"key":"1333_CR37","unstructured":"Greek Ministry of Health. Diagnosis related groups (DRG) list. 2012. www.moh.gov.gr. Accessed 2 Jul 2022."},{"issue":"5","key":"1333_CR38","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s40273-017-0606-1","volume":"36","author":"P Thokala","year":"2018","unstructured":"Thokala P, Ochalek J, Leech AA, Tong T. Cost-effectiveness thresholds: the past, the present and the future. Pharmacoeconomics. 2018;36(5):509\u201322.","journal-title":"Pharmacoeconomics"},{"issue":"1","key":"1333_CR39","doi-asserted-by":"publisher","first-page":"1447828","DOI":"10.1080\/16549716.2018.1447828","volume":"11","author":"D Cameron","year":"2018","unstructured":"Cameron D, Ubels J. On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data: a systematic review. Glob Health Action. 2018;11(1):1447828.","journal-title":"Glob Health Action"},{"key":"1333_CR40","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.vhri.2023.02.006","volume":"36","author":"C Tzanetakos","year":"2023","unstructured":"Tzanetakos C, Gourzoulidis G. Does a standard cost-effectiveness threshold exist? The case of Greece. Value Health Reg Issues. 2023;36:18\u201326.","journal-title":"Value Health Reg Issues."},{"key":"1333_CR41","unstructured":"International Monetary Fund. World economic outlook database. 2022. Available from: www.imf.org\/external\/pubs\/ft\/weo\/2019\/02\/weodata\/index.aspx. Accessed 12 Jun 2022."},{"issue":"3","key":"1333_CR42","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1097\/MEG.0000000000001916","volume":"33","author":"K Vellopoulou","year":"2021","unstructured":"Vellopoulou K, Stefanou G, Tzanetakos C, et al. Cost-effectiveness of tofacitinib for the treatment of moderate to severe active ulcerative colitis in Greece. Eur J Gastroenterol Hepatol. 2021;33(3):325\u201333.","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"1333_CR43","unstructured":"European Network for Health Technology (EUnetHTA). Guidelines: comparators & comparisons: direct and indirect comparisons. 2015. www.eunethta.eu\/wp-content\/uploads\/2018\/01\/Comparators-Comparisons-Direct-and-indirect-comparisons_Amended-JA1-Guideline_Final-Nov-2015.pdf. Accessed 1 Sep 2022."}],"container-title":["Clinical Drug Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40261-023-01333-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40261-023-01333-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40261-023-01333-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T12:32:16Z","timestamp":1704457936000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40261-023-01333-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,16]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["1333"],"URL":"https:\/\/doi.org\/10.1007\/s40261-023-01333-z","relation":{},"ISSN":["1173-2563","1179-1918"],"issn-type":[{"value":"1173-2563","type":"print"},{"value":"1179-1918","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,16]]},"assertion":[{"value":"29 November 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was funded by Pfizer Hellas.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"Argyro Solakidi and Eleni Nikitopoulou are employees of Pfizer Hellas. George Gourzoulidis, Argyro Solakidi, Marina Psarra, Eleni Nikitopoulou, and Charalampos Tzanetakos have no conflicts of interest that are directly relevant to the content of this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}},{"value":"Conceived the study: GG, CT, AS; designed the study: GG, CT, AS; analyzed the data: GG, CT; interpreted the data: GG, CT, AS, MP, EN; contributed to writing and review of the manuscript: GG, CT, AS, MP, EN. All authors approved the final version of the completed manuscript and agreed to be accountable for the entirety of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 Contributions"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"All data used to conduct this study are included in this article.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of Data and Material"}},{"value":"Not applicable.","order":9,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code Availability"}}]}}