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[Comment] Drivers of costly treatment strategies in rheumatoid arthritis

Different countries have taken different roadmaps to guide the prescription of expensive drugs. In the UK, a non-departmental public body called the National Institute for Health and Care Excellence; in the Netherlands, a similar public body called the Dutch National Health Care Institute; and in Iceland, a specialised committee recommend when expensive biological drugs will be reimbursed. These committees base their recommendations on the available clinical and economic evidence. In view of the scarcity of evidence on treatment strategies using expensive drugs in rheumatoid arthritis, some friction often occurs between the wish of doctors and the decisions made by official bodies.