Cost-Effectiveness of Adding Magnetic Resonance Imaging to Rheumatoid Arthritis Management

Magnetic Resonance Imaging (MRI) would not reduce the costs of assessing risk for rheumatoid arthritis (RA); in some cases treating all patients without knowledge of their risk levels would be preferable to adding MRI.

Early, aggressive treatment of RA incurs high costs; therefore it is important to treat only those individuals who are at high risk for RA. This study modeled the costs and benefits of using MRI to supplement standard risk stratification strategies.

This study employed decision analysis, deriving a hypothetical patient population from already published literature. The authors compared outcomes using standard risk stratification, standard plus MRI, and the “treat all” approach that forgoes risk stratification. The study estimated 12-month and lifetime RA-related costs in incremental cost-effectiveness ratios (ICERs); ICERs are expressed in U.S. dollars per quality-adjusted life-year gained.

Key Findings:

  • The lifetime ICER for adding MRI to standard RA risk stratification was $167,783 per quality-adjusted life years (QALY) gained (above the cost-effectiveness threshold of $100, 000 per QALY).
  • From a total of 70 variables modeled, only 5 resulted in cost-effective ICERs.

RA affects 1.5 million Americans every year. This study found that MRI would be ineffective at reducing the costs associated with assessing risk for RA.