Costs offset by biologic drugs in rheumatoid arthritis

Abstract: New biologics are effective yet expensive drugs for patients with Rheumatoid Arthritis (RA), and are fast becoming one of the largest components of pharmaceutical budgets.  The costs of biologics have been justified based on their health benefits and the associated reduction in non drug expenditures - in particular surgeries.  However, these cost offsets have been predicted based on association studies.  Using an administrative database, this study uses an instrument variable approach to attempt to overcome bias due to (unmeasured) confounding by indication so to estimate the proportion of biologic costs offset by reduced non drug expenditures.