Pharmacoeconomic study of tocilizumab dosing strategies as an intravenous solution in rheumatoid arthritis
Year: 2026
Type: article
Abstract: Tocilizumab (TCZ) is widely used in rheumatoid arthritis (RA) and may be administered using different dosing regimens, including the standard dose (SD) of 8 mg/kg and regimens involving dose reduction or escalation depending on the clinical response. Under current healthcare conditions, assessment of the clinical and economic feasibility of drug-dosing strategies is particularly relevant. Objective : to evaluate, from the perspective of the Russian healthcare system, the clinical and economic feasibility of a TCZ dose de-escalation strategy (DDS) from 8 to 4 mg/kg after remission is achieved and a dose escalation strategy (DES) from 4 to 8 mg/kg if remission is not achieved, compared with the SD of 8 mg/kg in patients with RA. Material and methods . A decision-tree model with 1and 3-year time horizons was developed to compare the three TCZ dosing strategies. Costminimization analysis, budget impact analysis, and one-way sensitivity analysis were performed. Results and discussion . Over a 1-year time horizon, DES provided savings of 169,850 rubles (28.1%) per patient compared with SD, whereas DDS provided savings of 58,188 rubles (9.6%). Over a 3-year time horizon, savings amounted to 168,849 rubles (10.3%) and 95,848 rubles (5.8%) for DES and DDS, respectively. According to the budget impact analysis, transferring a proportion of patients to DES could reduce costs by 1.0–1.7 billion rubles over 3 years, whereas transition to DDS could reduce costs by 0.6–1.0 billion rubles. Conclusion . Within the adopted assumptions, the model demonstrates a potential reduction in direct drug costs when using strategies involving controlled dose reduction or initiation at a lower dose followed by escalation. Owing to the limited availability of direct comparative data and regulatory restrictions in the Russian Federation, the results should be regarded as a scenario-based pharmacoeconomic assessment requiring validation using Russian data.
Source: Modern Rheumatology Journal
Authors: A. M. Lila, A. A. Vasilenko, E. V. Gerasimova, A. I. Dubikov, A. I. Zagrebneva, E. V. Zonova, L. V. Ivanova, T. N. Kargaeva, M. A. Korolev, A. I. Kulikov, D. I. Abdulganieva, S. A. Lapshina, G. V. Lukina, D. N. Malakhova, Z. Yu. Mutovina, P. I. Novikov, R. R. Samigullina, A. V. Torgashina, G. F. Fatkhullina, A. L. Chudinov, P. A. Shesternya, E. A. Trofimov
Institutions: Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Association of Rheumatologists of Russia, Moscow Clinical Scientific Center, Novosibirsk State Medical University, The First Republican Clinical Hospital of the Ministry of Health of the Udmurt Republic, Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Institute of Clinical and Experimental Lymphology, Kazan State Medical University, Sechenov University, North-Western State Medical University named after I.I. Mechnikov, Republican Clinical Hospital named after G.G. Kuvatova, Krasnoyarsk State Medical University
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7203677598