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Health economics in the treatment of inflammatory arthritis diseases

Project Manager


Target-directed treatment (Treat to target) is an important principle in the treatment of inflammatory arthritis diseases. The concept is based on healthcare personnel together with the patient choosing a realistic target for treatment of the disease. In some people, there may be an absence of all signs of the disease, in others, with a more challenging disease picture, there may be an absence of pain or the fact that the patient is able to stand at work. Once the target has been chosen, health personnel monitor the patient closely with frequent changes of medication if necessary, until the target is reached. After that, the control frequency may decrease somewhat. Although the health economics of the introduction of new medicines have been assessed in the past, the health economic consequences of target-directed treatment are less well known. The project is in the start-up phase.

‍"Long-term safety and effect of disease-modifying drugs in inflammatory joint disease -NOR-DMARD" is a prospective multicentre observational study that follows patients with inflammatory joint disease who receive immunomodulatory treatment. The study was established in 2000. The number of centers has varied over time, but today it is Diakonhjemmet Hospital, University Hospital in Tromsø, Rheumatism Hospital in Lillehammer and Førde Hospital that include patients in the study. NOR-DMARD contains long-term information on disease activity and the use of drugs in patients with inflammatory joint diseases. NOR-DMARD is connected to the Causes of Death Register, the Cancer Register, the Norwegian Patient Register, the Joint Prosthesis Register, the Vaccine Register, the FD social security system and the A scheme, and we thus receive information on the use of health services and participation in working life.

We also have a control cohort consisting of 10 individuals for each treatment course registered in NOR-DMARD. These controls are drawn from the population register and have the same year of birth, gender and place of residence as the patient in NOR-DMARD. The project also has access to data from other sources such as NORARTRITT and the Prescription Register. We work closely with researchers at Health Economics at the University of Oslo.


All patients receiving treatment with a biological immunomodulating drug against inflammatory joint disease at a participating hospital will be asked to participate in the NOR-DMARD study and thus in NORECON.


All consenting patients who were treated with disease-modifying and/or biological immunomodulating drugs were included until 2011. In 2012, the protocol was changed and "New NOR-DMARD" only includes patients who start biological treatment. Participating patients are followed in a fixed control scheme and regularly answer questionnaires about perceived disease activity. Healthcare professionals also enter information from clinical examinations and record treatment that has been given.