Results from the multicenter Dutch Rheumatoid Arthritis Monitoring Registry (DREAM) study show that in patients with early rheumatoid arthritis (RA), a treat-to-target strategy achieves better regression and greater long-term cost savings than conventional therapy. Treat-to-target refers to a treatment regimen to achieve and maintain remission as soon as possible through regular monitoring of disease activity and the use of fixed medication modifications. In this study, Ms. MarloesVermeer, a PhD student at the University of Twente in Enschede, the Netherlands, and colleagues analyzed costs using the incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) based on Dutch cost analysis guidelines and data from the Dutch Health Insurance Agency after determining the amount of treatment the patient received and the cost per treatment volume consumed. The study yielded an ICER of €3591 (approximately$4900), representing the cost per additional patient who achieved remission, and an ICUR of €19,410 ($26,530), representing the cost per quality-adjusted life year (QALY) gained. Attainment treatment strategies dominated at year 2 and 3 follow-up. The investigators followed a cohort of 2 RA patients admitted to 11 DREAM study centers for at least 2 years from initial diagnosis. The attainment group initially included 261 patients diagnosed between January 2006 and February 2009 who received methotrexate monotherapy initially, followed by salazosulfapyridine and, if disease activity persisted, anti-tumor necrosis factor (TNF) agents instead of salazosulfapyridine. The investigators said they expect that the attainment strategy will continue to be cost effective in the long term and that it will result in better and earlier control of the disease, facilitating early participation in work and social activities. In addition, the attainment strategy contributes to an overall improvement in quality of life. With attainment, the extra effort and time spent in the first year of illness ultimately leads to fewer visits thereafter and, for patients who achieve sustained remission, a gradual reduction in medication discontinuation, thereby reducing costs.