{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:57:46Z","timestamp":1785459466232,"version":"3.56.0"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T00:00:00Z","timestamp":1638057600000},"content-version":"vor","delay-in-days":331,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004320","name":"Shiraz University of Medical Sciences","doi-asserted-by":"publisher","award":["97-01-07-18106"],"award-info":[{"award-number":["97-01-07-18106"]}],"id":[{"id":"10.13039\/501100004320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>. Rheumatoid arthritis (RA) is a chronic progressive inflammatory disease that causes joint destruction. The condition imposes a significant economic burden on patients and societies. The present study is aimed at evaluating the cost\u2010effectiveness of Infliximab, Adalimumab, and Etanercept in treating rheumatoid arthritis in Iran. <jats:italic>Methods<\/jats:italic>. This is a cost\u2010effectiveness study of economic evaluation in which the Markov model was used. The study was carried out on 154 patients with rheumatoid arthritis in Fars province taking Infliximab, Adalimumab, and Etanercept. The patients were selected through sampling. In this study, the cost data were collected from a community perspective, and the outcomes were the mean reductions in DAS\u201028 and QALY. The cost data collection form and the EQ\u20105D questionnaire were also used to collect the required data. The results were presented in the form of an incremental cost\u2010effectiveness ratio, and the sensitivity analysis was used to measure the robustness of the study results. The TreeAge Pro and Excel softwares were used to analyze the collected data. <jats:italic>Results<\/jats:italic>. The results showed that the mean costs and the QALY rates in the Infliximab, Adalimumab, and Etanercept arms were $ 79,518.33 and 12.34, $ 91,695.59 and 13.25, and $ 87,440.92 and 11.79, respectively. The one\u2010way sensitivity analysis confirmed the robustness of the results. In addition, the results of the probabilistic sensitivity analysis (PSA) indicated that on the cost\u2010effectiveness acceptability curve, Infliximab was in the acceptance area and below the threshold in 77% of simulations. The scatter plot was in the mentioned area in 81% and 91% of simulations compared with Adalimumab and Etanercept, respectively, implying lower costs and higher effectiveness than the other two alternatives. Therefore, the strategy was more cost\u2010effective. <jats:italic>Conclusion<\/jats:italic>. According to the results of this study, Infliximab was more cost\u2010effective than the other two medications. Therefore, it is recommended that physicians use this medication as the priority in treating rheumatoid arthritis. It is also suggested that health policymakers consider the present study results in preparing treatment guidelines for RA.<\/jats:p>","DOI":"10.1155\/2021\/4450162","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T02:10:24Z","timestamp":1638151824000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Cost\u2010Effectiveness Analysis of Biopharmaceuticals for Treating Rheumatoid Arthritis: Infliximab, Adalimumab, and Etanercept"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1851-159X","authenticated-orcid":false,"given":"Ahmad","family":"Gholami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4751-6093","authenticated-orcid":false,"given":"Jassem","family":"Azizpoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1191-1494","authenticated-orcid":false,"given":"Elham","family":"Aflaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2241-4402","authenticated-orcid":false,"given":"Mehdi","family":"Rezaee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-5502","authenticated-orcid":false,"given":"Khosro","family":"Keshavarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-007-0357-y"},{"key":"e_1_2_11_2_2","article-title":"Biological agents in rheumatoid arthritis","volume":"50","author":"Shankar S.","year":"2004","journal-title":"Journal of Postgraduate Medicine"},{"key":"e_1_2_11_3_2","article-title":"Safety of rituximab in rheumatoid arthritis","volume":"101","author":"Covelli M.","year":"2011","journal-title":"Reumatismo"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/727634"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.042440"},{"key":"e_1_2_11_6_2","first-page":"27","article-title":"Expanding role of biologic agents in rheumatoid arthritis","volume":"66","author":"Kalden J. 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