Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

Santos, Jéssica Barreto Ribeiro dos; Almeida, Alessandra Maciel; Acúrcio, Francisco de Assis; Oliveira, Haliton Alves de; Kakehasi, Adriana María; Guerra, Augusto Afonso; Bennie, Marion; Godman, Brian; Álvares, Juliana

doi:10.2217/cer-2016-0027

Cited by 13 publications

(13 citation statements)

References 38 publications

(34 reference statements)

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“…Adalimumab was the most requested anti-TNF agent, followed by etanercept. This anti-TNF utilization profile is consistent with the literature, where adalimumab has been the medication most commonly utilized in the treatment of PsA and other rheumatic diseases in Brazil [33][34][35]. This could be partially explained as adalimumab presents additional treatment indications, such as uveitis, and this is a characteristic that is not shared with etanercept.…”

Section: Discussionsupporting

confidence: 89%

Medication Persistence for Psoriatic Arthritis in a Brazilian Real-World Setting

et al. 2019

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Aim: To evaluate the persistence of biological (TNF inhibitor [anti-TNF]) and synthetic (conventional synthetic disease-modifying antirheumatic drugs [csDMARDs]) antirheumatic agents for psoriatic arthritis and their associated factors. Methods: A historical cohort was developed. Persistence and associated factors were evaluated at 6 and 12 months. Results: A total of 161 patients were included. The anti-TNF treatment presented higher persistence as compared with csDMARDs at 6 (83.4 vs 50.8%; p < 0.05) and 12 months (66.4 vs 35.6%; p < 0.05). From anti-TNFs, adalimumab and etanercept presented similar persistence, along with leflunomide and methotrexate among the csDMARDs. The factors associated with non-persistence with regard to anti-TNF agents were female sex and use of infliximab. Conclusion: Anti-TNF agents are important therapeutic alternatives and present lower rates of discontinuation as compared with csDMARDs.

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Section: Discussionsupporting

confidence: 89%

Medication Persistence for Psoriatic Arthritis in a Brazilian Real-World Setting

et al. 2019

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“…These examples of MEAs can be seen as part of a general approach within healthcare systems to monitor the effectiveness, safety and value of new medicines where possible especially where there are concerns initially with their effectiveness, safety and value in routine clinical care (144,(147)(148)(149)(150)(151)(152)(153)(154)(155)(156) . In addition, be part of a general move away from a policy model of one-time evaluation regarding the incorporation of a new technology into health care systems towards a model of multiple evaluations of new health technologies over time.…”

Section: Challenges and Benefits From Measmentioning

confidence: 99%

Integrative Review of Managed Entry Agreements: Chances and Limitations

et al. 2020

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Introduction: Managed Entry Agreements (MEAs) consist of a set of instruments to reduce the uncertainty and the budget impact of new high priced medicines; however, there are concerns. There is a need to critically appraise MEAs with their planned introduction in Brazil. Accordingly, the objective is to identify and appraise key attributes and concerns with MEAs among payers and their advisers, with the findings providing critical considerations for Brazil and other high-and middle-income countries. Methods: An integrative review approach was adopted. This involved a review of MEAs across countries. The review question was 'What are the health technology MEAs that have been applied around the world?' This review was supplemented with studies not retrieved in the search known to the senior level co-authors including key South American markets. Afterall, involved senior level decision makers and advisers providing guidance on potential advantages and disadvantages of MEAs and ways forward. Results: 25 studies were included in the review. Most MEAs included medicines (96.8%), focused on financial arrangements (43%), and included mostly antineoplastic medicines. Most countries kept key information confidential including discounts or had not published such data. Few details were found in the literature regarding South America. Our findings and inputs resulted in both advantages including reimbursement and disadvantages including concerns with data collection for outcome-based schemes. Conclusion: We are likely to see a growth in MEAs with the continual launch of new high priced and often complex treatments, coupled with increasing demands on resources. Whilst outcome based MEAs could be an important tool to improve access to new innovative medicines there are critical issues to address. Comparing knowledge, experiences and practices across countries is crucial to guide high-and middle-income countries when designing their future MEAs.

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“…In this review, judicialized medicines for the treatment of chronic diseases, autoimmune, and rare genetic diseases represented the greatest impact on the budget of public health policies 24,26,30,33,41,42,45,46,54,[80][81][82] . Although many drugs are well tolerated and achieve goals of remission, low activity or control of these diseases, the main causes of the evolution of expenditures are the preferences of prescribers and the success of judicial demands, without considering the cost-effectiveness of these medicines 75,[83][84][85] . The articles usually only mentioned expenditures and growth trends, suggesting the need for greater financial control of health policies [78][79][80] .…”

Section: Discussionmentioning

confidence: 99%

The quality of research on judicialization and its influence on public policies on access to medicines in Brazil: a systematic review

Lyra

Araújo

Júnior

et al. 2021

Ciênc. saúde coletiva

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Patients without access to medicines often resort to the judicial system. However, no systematic review has discussed the quality of studies and the factors that may influence the access to medicines from judicialization. This study aimed to characterize the quality of research on access to judicialized medicines and their influence on public policies in Brazil. A search was conducted in the LILACS, PubMed/Medline, Scopus, and Web of Science databases using the terms “judicialization” and “medication”. Two reviewers identified articles that met the inclusion criteria. Only studies written in English, Portuguese, or Spanish published from 1990 to 2018 were included. The study selection resulted in a final sample of 45 articles. The retrospective descriptive design was the most common methods, based on reports and lawsuits. A high level of heterogeneity among the studies hindered the comparison and generation of evidence capable of supporting judges’ decisions based on technical-scientific criteria. This review showed that studies were heterogeneous and had low methodological quality. Moreover, they did not propose viable solutions for health managers and formulators to face the problem.

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Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

Cited by 13 publications

References 38 publications

Medication Persistence for Psoriatic Arthritis in a Brazilian Real-World Setting

Medication Persistence for Psoriatic Arthritis in a Brazilian Real-World Setting

Integrative Review of Managed Entry Agreements: Chances and Limitations

The quality of research on judicialization and its influence on public policies on access to medicines in Brazil: a systematic review

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