Extract

University Medical Centre Nijmegen, Department of Rheumatology, Nijmegen and 1Maastricht University, Department of Health Organisation, Policy and Economics, Maastricht, The Netherlands

Sir, Kobelt et al. [1] describe a modelling study into the cost-effectiveness of infliximab plus methotrexate treatment compared with methotrexate treatment alone over 10 yr in patients with advanced disease.

They use the results of the ATTRACT trial and a Markov model with health states defined by the Health Assessment Questionnaire (HAQ) to simulate the 10-yr follow-up of the patients in the clinical trial. Transition probabilities and costs and utility values for the health states are calculated using data from the Lund and ERAS cohorts. The results indicate that (1 to 2 yr) treatment with infliximab results in cost-effectiveness ratios well within the usual range for treatment to be recommended for use [1].

Unfortunately we believe that the study has some implicit assumptions that might result in too optimistic results.

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