Health economics of treating inflammatory arthritic diseases

project manager


phd fellow

About the project

Treat to target is an important principle in the treatment of inflammatory arthritic diseases. The concept involves health professionals working with the patient to choose a realistic target for treating the disease. For some people, this may be the absence of all signs of the disease; for others, with a more challenging disease picture, it may be the absence of pain or the ability to work. Once the target has been chosen, the healthcare professional follows the patient closely with frequent changes of medication if necessary, until the target is reached. Thereafter, the frequency of monitoring may decrease somewhat. Although the health economics of introducing new drugs have been assessed in the past, the health economic consequences of goal-directed therapy are less well known. The project is in its start-up phase.

"Long-term safety and efficacy of disease-modifying drugs in inflammatory joint disease -NOR-DMARD" is a prospective multicenter observational study following patients with inflammatory joint disease receiving immunomodulatory therapy. The study was established in 2000. The number of centers has varied over time, but today Diakonhjemmet Hospital, the University Hospital in Tromsø, the Rheumatism Hospital in Lillehammer and Førde Hospital include patients in the study. NOR-DMARD contains long-term information on disease activity and drug use in patients with inflammatory joint diseases. NOR-DMARD is linked to the Cause of Death Registry, the Cancer Registry, the Norwegian Patient Registry, the Joint Prosthesis Registry, the Vaccine Registry, the National Insurance Scheme and the A scheme, and we thus obtain information on the use of health services and participation in working life.

In addition, we have a control cohort consisting of 10 individuals for each treatment course registered in NOR-DMARD. These controls are drawn from the National 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 Norwegian Prescription Register. We collaborate closely with researchers in Health Economics at the University of Oslo.

Who can participate?

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

Project arrangement

All consenting patients treated with disease-modifying and/or biological immunomodulatory drugs were included until the end of 2011. In 2012, the protocol was changed and "New NOR-DMARD" includes only patients starting biological treatment. Participating patients are followed in a fixed follow-up schedule and regularly answer questionnaires on perceived disease activity. Healthcare professionals also enter information from clinical examinations and record treatment given.


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