Stuart D. Segal, MD

This study supports earlier research on the comparative effectiveness of tumor necrosis factor (TNF) blockers in rheumatoid arthritis (RA) patients, but is unique in utilizing both clinical outcomes data from US clinical practices and actual drug utilization data from claims. 

Increased costs resulting from TNF blocker dose escalation may not always be accompanied by an improvement in clinical benefit. 

In the current comparative effectiveness research paradigm, understanding the clinical benefit gained from additional cost is critical to payers.

Among RA patients newly treated with adalimumab, etanercept, or infliximab, lower dose escalation rates and costs were seen with etanercept.

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Among rheumatoid arthritis patients newly treated with adalimumab, etanercept, or infliximab, lower dose escalation rates and costs were seen with etanercept.