Yun Jong Lee

doi:10.4078/jrd.2014.21.3.107

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Lee: Usage of Anti-TNFα Agents in Patients with Rheumatoid Arthritis and Korean National Health Insurance Reimbursement Criteria

Editorial

J Rheum Dis 2014;21(3):107-109.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.3.107

Usage of Anti-TNFα Agents in Patients with Rheumatoid Arthritis and Korean National Health Insurance Reimbursement Criteria

Yun Jong Lee

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine, Seoul, Korea

Corresponding to: Yun Jong Lee, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, 173beon-gil, Gumi-ro, Bundang-gu, Seongnam 463-707, Korea. E-mail: yn35@snu.ac.kr

Received 8 June 2014 Revised 21 June 2014 Accepted 23 June 2014

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

REFERENCES

1. Verstappen SM, Bijlsma JW, Verkleij H, Buskens E, Blaauw AA, ter Borg EJ, et al. Utrecht Rheumatoid Arthritis Cohort Study Group. Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum. 2004; 51:488–97.

2. Son KM, Jung DM, Kim YB, Han JS, Seo YI, Jung YO, et al. Comparison Korean National Health Insurance Reimbursement and Other Guidelines for TNF-alpha Blocker in Rheumatoid Arthritis. J Rheum Dis. 2012; 19:334–40.

3. Son KM, Jung YO, Kim IJ, Kim BJ, Lee SY, Mun SY, et al. Clinical Characteristics of Korean Rheumatoid Arthritis Patients with Indications for TNF-alpha Blocker. J Rheum Dis. 2013; 20:356–60.

4. Won S, Sung YK, Cho SK, Choi CB, Koh EM, Kim SK, et al. Prediction for TNF Inhibitor Users in RA Patients According to Reimbursement Criteria Based on DAS28. J Rheum Dis. 2014; 21:64–73.

5. Lethaby A, Lopez-Olivo MA, Maxwell L, Burls A, Tugwell P, Wells GA. Etanercept for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2013; 5:CD004525.

6. Wolfe F, Michaud K, Pincus T, Furst D, Keystone E. The disease activity score is not suitable as the sole criterion for initiation and evaluation of anti-tumor necrosis factor therapy in the clinic: discordance between assessment measures and limitations in questionnaire use for regulatory purposes. Arthritis Rheum. 2005; 52:3873–9.

7. Bakker MF, Jacobs JW, Kruize AA, van der Veen MJ, van Booma-Frankfort C, Vreugdenhil SA, et al. Misclassification of disease activity when assessing individual patients with early rheumatoid arthritis using disease activity indices that do not include joints of feet. Ann Rheum Dis. 2012; 71:830–5.

8. Leeb BF, Haindl PM, Maktari A, Nothnagl T, Rintelen B. Disease activity score-28 values differ considerably depending on patient's pain perception and sex. J Rheumatol. 2007; 34:2382–7.

9. Ranzolin A, Brenol JC, Bredemeier M, Guarienti J, Rizzatti M, Feldman D, et al. Association of concomitant fibromyalgia with worse disease activity score in 28 joints, health assessment questionnaire, and short form 36 scores in patients with rheumatoid arthritis. Arthritis Rheum. 2009; 61:794–800.

10. www.cpg.or.kr/files/guideline/1384324864374.xml

Table 1.

New reimbursement criteria and Clinical Research Center for Rheumatoid Arthritis recommendations for biologic agents in patients with rheumatoid arthritis

기준	국민건강보험 급여기준	CRCRA 권고안
개시
비생물학적	6 개월 이상	항류마티스약제를 적절히 사용하고 3개월이
항류마티스약제 사용기간		경과한 이후에도 관해 또는 낮은 질환 활성
DAS28 기준	5.1 초과	도에 도달하지 못할 경우
	3.2∼5.1이고 영상 검사상 관절 손상의 진행	항류마티스약제를 사용하지 않은 환자라도, 나
		쁜 예후인자가 있으면서 질병 활성도가 높
		을 경우
유지
DAS28 기준	6개월 후 1.2 이상 감소
교체	효과가 없거나 부작용으로 투약을	일차 생물학적 제제를 적절히 사용하고 난 이
	지속할 수 없는 경우	후에도 관해에 도달하지 못한 경우
	교체투여에 대한 투여소견서를 첨부

DAS28: Disease Activity Score in 28 joints, CRCRA: Clinical Research Center for Rheumatoid Arthritis.

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