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Modelling the cost-effectiveness of early biologic disease modifying anti-rheumatic drugs (bDMARDs) treatment for patients with juvenile idiopathic arthritis.

Haan, R.J. (2021) Modelling the cost-effectiveness of early biologic disease modifying anti-rheumatic drugs (bDMARDs) treatment for patients with juvenile idiopathic arthritis.

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Abstract:Juvenile idiopathic arthritis (JIA) is a chronic disease affecting children which can result in irreversible joint damage resulting in lifelong health issues. The prospect of remission and general health outcomes has improved in the last decennia's due to the introduction of synthetic disease modifying anti-rheumatic drugs (sDMARDs). However, there is still a fraction of JIA patients that do not respond adequately to sDMARDs. For these patients a biologic DMARD (bDMARD) can be prescribed. bDMARDs are far more expensive than sDMARDs but can achieve better health outcomes especially for patients with severe JIA. The step-up approach of using a bDMARD after the failure of a sDMARD is the conventional treatment strategy. However, due to the better health outcomes of bDMARD the question is raised if bDMARDs should be used earlier in the treatment of JIA. With limited resources health care decision makers need to allocate resources appropriately. As bDMARDs can be 20 up to 500 times more expensive than sDMARDs a cost-effectiveness analysis needs to be conducted on the early use of bDMARDs. In this thesis a state transition model is developed for the estimation of the cost-effectiveness of early bDMARDs treatment in JIA.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine, 85 business administration, organizational science
Programme:Industrial Engineering and Management MSc (60029)
Link to this item:http://purl.utwente.nl/essays/88131
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