Cost-effectiveness of risk-stratified blood test monitoring strategies for adults with inflammatory conditions
Authors' conclusion
Extending the interval between monitoring blood tests appears to be cost-effective with annual monitoring producing consistently good results regardless of assumptions related to risks of AEs, risk decile or treatment.
Study context
- Population
- Adults with inflammatory conditions on established treatment with low-dose weekly MTX (≤25 mg/week), LEF or SSZ
- Comparison
- 6-, 12- and 24-monthly monitoring blood tests vs 3-monthly monitoring
- Outcome
- iNMB of 6-, 12- and 24-monthly vs 3-monthly monitoring, for each drug by risk decile
- Follow-up
- 5 years of established treatment
Methodological detailsmodel-based, prognostic models incorporated, risk-decile stratified, pessimistic sensitivity analysis, Risk of 1 of 11 avoidable adverse events (AEs) estimated by clinicians, who erred towards overestimating the risks, AE costs and QALY loss sourced from recent NICE appraisals or targeted searches
- Model-based
- Prognostic models incorporated
- Risk-decile stratified
- Pessimistic sensitivity analysis
- Risk of 1 of 11 avoidable AEs estimated by clinicians, who erred towards overestimating the risks
- AE costs and QALY loss sourced from recent NICE appraisals or targeted searches
Performance
As reported in the abstract
Cost-effectiveness (iNMB) of extended monitoring intervals
- Extending the duration between monitoring appointments is cost-effective in all scenarios, including a pessimistic analysis (risks of all AEs tripled, costs of some AEs increased)
- Base case: biennial monitoring often most cost-effective, although incremental net monetary benefit (iNMB) between annual and biennial monitoring often small
Original publication
Cost-effectiveness of risk-stratified blood test monitoring strategies for adults with inflammatory conditions. Rheumatology (Oxford). Published 21 November 2025. doi:10.
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