The most widely used domestic biologics in the field of rheumatology is the tumor necrosis factor antagonist class, the other for spondyloarthritis or ankylosing spondylitis is either ineffective or not yet available, rheumatologists have not found that such drugs can really change the course and prognosis of ankylosing spondylitis, but the means of treatment for this type of disease is too few, and sometimes have to make recommendations to patients. So the biggest prerequisite for a recommendation is affordability. Patients cannot spend their lifetime of treatment money in six months, and must reasonably choose a program that suits them according to their own and their family’s ability to afford it. The process of a good doctor’s visit is actually the process of identifying the patient’s problem and finding a treatment program that suits that patient based on the patient’s specific situation and the patient. There are luxury programs like a rich man driving a Rolls Royce, and there are economic programs like a civilian riding an electric car or a bicycle, and of course some people like Charlies and Audis can be mastered according to their own personal conditions, and this process should not cause excessive economic pressure on the patient. Because riding a bicycle is supported by the state reimbursement may be greater, driving a luxury car is not supported by the state you personally must have sufficient silver. There are several cases we still recommend the use of biological agents, such as hip inflammation is particularly high disability rate of patients, the cost of drugs is much less than the cost of joint replacement, generally all rheumatologists will try to convince you to use, if it is not very difficult must not hesitate, if bear up a little strain just cause short-term life difficulties should also create the conditions to apply. The second situation is the combination of bull `, iritis and inflammatory bowel disease patients, there is better evidence of good results of biological agents, you can also strive to use, but do not take loans and buy a house, because in addition to biological agents, the doctor will still give you some economic solutions may also be well controlled. The third situation is that after trying 2-3 kinds of programs are not ideal, of course, this program must be the regular hospital rheumatology professional doctors to give you rather than charlatan doctors, grassroots doctors or playing the Chinese medicine guise of fraudulent people to give you the program, this time biological agents is also a good choice, but before using or to calculate the accounts, because no unit and no individual will earn money for you, you earn the money Once spent regardless of the effect will not come back, if you have confidence in the doctor may find a fifth program to. The fourth case is the ultra-early patient inflammatory manifestations have very heavy, this time the application has the potential to nip the disease in the bud, a little positive or necessary. There are several situations that friends are advised not to tough it out if they don’t have money. If the spine has been bamboo-like, the sacroiliac joint has been ankylosed, the hip joint has been significantly damaged, the MRI inflammation has been insignificant, the blood sedimentation and c-reactive protein are not high, this kind of patient will not achieve any real improvement of the disease no matter what drugs are used. The patient should consider how to exercise, how to live, how to reduce pain with medication, but not to use any medication that is more than he or she can afford or any program that is not carried out by doctors in regular hospitals, but to set aside some money for future surgery. There is also a case of patients with a long course of the disease but with generally normal test results and few abnormalities, most of them will not progress too fast even without treatment, and you have plenty of time to choose slowly, so it is not necessary to try to be righteous and choose up to the program. If you really need to use biological agents, the following is to choose how to use biological agents, currently there are five domestic tumor necrosis factor antagonists can be bought: the first Enry is definitely high, the world’s top three large companies produce, pure imports, the first listed in the biological agents, the longest application time, the most experienced doctors, but the normal application of adults (25mg twice a week each time) a month of The cost needs more than 20,000 yuan, the cost of the American application is less than 10,000 yuan, the huge difference between Chinese and foreign always makes people feel uncomfortable, but the safety and effectiveness of the drug is really good, the money does not care about the first choice, pediatric if really need to use as the first choice, the quality and safety or the most reassuring, the drug currently has to buy eight to send two activities. The second drug is the class gram, normal people at least 12,000 once the cost (two prices, overweight friends may need 3-4) will block a large number of people, the regular use of the program is also different from the other four drugs, spinal arthritis need to repeat the second week, and every six weeks thereafter. However, the drug’s powerful action and rapid onset of action are its greatest advantages, and it is particularly suitable for patients with more complications, but friends with a history of co-infection, tuberculosis and tumors should not use it, and caution should be exercised for those older than 60 and younger than 12, because the cost of the strongest action is the most side effects and the greatest risk. In addition, the biggest difference between this drug and several other biologics is the need for intravenous infusion, this large molecule drug infusion to have strict requirements and need to be specially trained nurses to carry out, the high incidence of infusion reaction makes its application is very limited. But the company now has a buy four get two free campaign is also very tempting. The third drug is Xiomel, also an imported brand, between the first two imported drugs, both in terms of effectiveness and side effects between the first two, the compromise positioning and price make it the world’s largest-selling biologics, although it is the latest to market. Also fixed fortnightly subcutaneous injection is extremely convenient, a price of more than 7,000 exceeds the capacity of more than 90% of the patient’s wallet to see the hospital, but the swipe card no problem. But the Chinese market has been doing poorly, the company currently has a buy five get three free campaign. The fourth drug is Ixep, the national brand of state-run enterprises, is also the earliest biologics listed in China, almost a decade later than the United States (this is the gap ah), because the effect is sure, the price is relatively affordable, making him a street drug, there is no doctor and patient who does not know this drug, and there is no local city that can not buy this drug, sales may be equivalent to the sum of the other four drugs. And the nature of the same Enry but not exactly the same, the effect of catching up with the class grams and Xumel but safety is better, the price is relatively affordable, the normal application of adults (25mg twice a week each time) the cost of a month about seven thousand dollars, the disadvantage is rarely to engage in preferential activities, the price has not changed much since the market. The fifth is also the same as the nature of the Enzyme, Yicep, but not exactly the same domestic varieties of strong gram, the price is more affordable, the normal application of adults (25mg twice a week each time) cost about six thousand dollars a month, but than the oral drug still seems to be enough class, due to the late listing, may be from the perspective of competition to consider the pricing is low, although the visibility and use of the first four drugs can not catch up, but the potential is huge. The above costs refer to the approach of regular use in adults of normal weight, the circulating reduction program is an irregular program, the amount of reduced effect must also be discounted, so it is suitable for the maintenance of the disease after stabilization, if there is no stable situation or recommend the application of regular methods, in addition, it is not recommended to use more than four times the interval of normal use, so that there may have been no practical significance, nor is it recommended that the class of grams using extended The interval of the program, because the drug has the greatest chance of resistance, do not extend the time effect may have decreased, the effect of the extension is inevitable. There is also a recommendation is that unless the economic strength can support lifelong application, or and oral drug combination is better. In addition, I personally oppose the three months a course of treatment, three months is only the time when the biological agents play the maximum effect, the inevitable result of this time to stop the drug is a relapse, so there must be oral drugs to maintain or slowly reduce the amount.