Real-World Quality-Adjusted Life-Years Gains in Portuguese Patients with Rheumatoid Arthritis Following 1 Year of Golimumab Treatment

We aimed to measure QALY gains following 1 year of golimumab treatment in Portuguese RA patients in a real-world setting and calculated the number needed per QALY gained (NNQ). Data were collected from the national RA registry (Reuma.Pt) for all registered biologic-naïve patients aged >18 years diagnosed with active RA who started and remained on golimumab combined with methotrexate for at least 52 weeks (Study period: March 2011 – August 2015). QALY values were calculated through the sum of each patient EQ-5D utility value [derived from the health assessment questionnaire disability index (HAQ) scores by applying a validated algorithm: EQ-5D = 0.9567 – (0.306 x HAQ)] multiplied by the corresponding follow-up time. The NNQ (i.e. the number of patients one has to treat in order to gain 1 QALY) was calculated as the inverted value of the utility gain over 1 year. From the 54 subjects with at least 52 weeks of treatment with the information regarding HAQ, 19 (35.2%) achieved functional remission (i.e. HAQ<0.5). 88.9% were women, with mean age 56.6 (SD 12.1) years, disease duration 9.0 (SD 7.3) years, mean DAS28 3.3 (SD 1.2), HAQ score 0.9 (SD 0.7), and EQ-5D utility score 0.7 (SD 0.2). We observed significant gains in the quality of life and 81.3% of patients gained QALY. The mean QALY gain was 0.16 per patient and the NNQ was 6.25. Based on these data we estimated an incremental cost-effectiveness ratio of less than previously published figures (i.e. <60,000 €/QALY). However, this analysis was limited by a short time horizon and limited cost data available (e.g. productivity gains were not included). In this real-world study we observed a significant functional remission and an improvement on the quality of life of RA patients treated with golimumab in Portugal. Furthermore, the vast majority of patients gained QALY.