Improvement at Any Cost? The Art and Science of Choosing Treatment Strategies for Rheumatoid Arthritis

In this issue, Bansback and colleagues report a cost-effectiveness analysis using data from the RACAT (Rheumatoid Arthritis Comparison of Active Therapies) trial, which established the noninferiority of triple therapy with conventional disease-modifying antirheumatic drugs (sulfasalazine, hydroxychloroquine, and methotrexate) compared with etanercept and methotrexate. The editorialists discuss the findings suggesting that the difference in effectiveness between the strategies may be too small to justify the large cost difference, noting that if biosimilars can deliver similar clinical benefit at lower cost, they may offer new treatment opportunities that would not strain limited health care resources.

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