Kosteneffectiviteit van biologicals

Conflict of interest: The institution of Dr. M. Bijl has received an unrestricted grant from Solvay Pharmaceuticals and Novartis Pharma. Dr. A.A. van Bodegraven has received remuneration for travelling to a congress, consultancy and giving lectures for Abbott and Centocor. Prof. W.F. Lems has received consulting fees and fees for review activities from Abbot, Schering, MSD and Roche. Prof. E. Prens has received remuneration for board membership and giving lectures for Abbott, Wyeth, Janssen-Cilag, Shering-Plough. His institution has received grants from Pan Genetics and Wyeth, Invest. Prof. J.W.J. Bijlsma has received remuneration for consultancy and travelling to a congress from Abbott, Roche, Pfizer, Merck, Bristol-Myers Squibb, UCB. His institution has received grants from these same companies. Financial support for this article: none declared.

• Where health care is concerned, the introduction of biologicals has greatly improved the treatment of chronic inflammatory disorders.

• This class of drugs is not only noticeably effective, but is also well tolerated.

• The cost effectiveness of these drugs means that there are limits to their use. This is the other face of success.

• The Dutch Ministry of Health, Welfare and Sport recently announced measures intended to limit the growth of costs while at the same time requiring that savings should be made on the current budget.

• Recently the Canadian Agency for Drugs and Technologies in Health (CADTH) produced a report on the effects and costs of biologicals for adults with rheumatoid arthritis (www.cadth.ca). Here we discuss their findings.

• Organizations for medical specialists should be societal aware and be able to deal with these drugs in a cost-conscious manner, including the development of dynamic guidelines and quality visitations.