Biologic Therapy in Rheumatoid Arthritis: Integrating Clinical Advances With Social and Economic Perspectives

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation, joint destruction, and systemic complications. Over the past two decades, biologic disease-modifying antirheumatic drugs (bDMARDs) have transformed the therapeutic landscape of RA by targeting specific immune pathways. This review integrates current clinical evidence on biologic therapy with social and economic perspectives, emphasizing the broader implications of these innovative treatments. A narrative review of peer-reviewed literature published between 2000 and 2025 was conducted using PubMed, Scopus, and Web of Science databases. The analysis focuses on therapeutic efficacy, safety, cost-effectiveness, health technology assessment (HTA), access disparities, and the role of biosimilars and digital health technologies. Biologic agents, including TNF inhibitors, IL-6 receptor antagonists, B-cell–depleting agents, and T-cell costimulation modulators, demonstrate superior efficacy in moderate-to-severe RA compared to conventional synthetic DMARDs. However, high treatment costs and infrastructure requirements create substantial disparities in access globally. The emergence of biosimilars and value-based healthcare models has improved affordability in several regions. Integrating biomedical innovation with economic sustainability and social equity remains essential for optimizing RA care. Future research should emphasize real-world evidence, long-term economic modeling, and digital integration strategies to ensure equitable and sustainable implementation of biologic therapy.