对于类风湿性关节炎（RA）的TNF-a-i治疗的成本效用证据进行系统回顾，并估计汇总的增量净效益（INBp）。我们在PubMed、Embase、Scopus和Tufts Medical Centers' cost-effective analysis registry进行系统搜索后，选择了经济评估研究，报告了TNF-a-i与其他疾病修饰抗风湿药（DMARDs）相比的成本效用。结果以购买力平价调整的美元汇报，同时附带95％置信区间。我们使用GRADE质量评估来提供证据总结，并使用随机效应荟萃分析综合评估TNF-a-i的成本效用。我们纳入了86个研究进行系统回顾，其中27个研究进行荟萃分析。与其他DMARDs相比，TNF-a-i不具备成本效益性[-4,129（-6,789至-1,469）]，但存在较高的异质性。没有出版偏倚的证据（p = 0.447）。在单独的分析中，与RA治疗的常规合成DMARDs相比，TNF-a-i对成本效益不具备优势[-4,805 (-7,882至-1,728)]。GRADE评估显示对汇总的成本效用结果缺乏高度置信度，并可能存在风险偏倚。根据研究期间可获得的证据，与其他DMARDs相比，TNF-a-i对于治疗RA并不具备成本效益。然而，高异质性和GRADE质量评估的低置信度使得结果无法推广。

To systematically review cost-utility evidence of TNF-a-i treatment for Rheumatoid arthritis (RA) and to estimate the pooled incremental net benefit (INBp).We selected economic evaluation studies reporting the cost-utility of TNF-a-i compared to other disease-modifying anti-rheumatic drugs (DMARDs) after a systematic search in PubMed, Embase, Scopus, and Tufts Medical Centers' cost-effective analysis registry. The results were reported as pooled INB in purchasing power parity-adjusted US dollars, along with 95% confidence intervals. We used GRADE quality assessment to present summaries of evidence and random-effects meta-analysis to synthesise cost-utility of TNF-a-i.We included 86 studies for systematic review, of which 27 for meta-analysis. TNF-a-i is not cost-effective [$ -4,129(-6,789 to -1,469)] compared to other DMARDs but with high heterogeneity. There was no evidence of publication bias (p=0.447). On separate analysis, TNF-a-i is not cost-effective [$-4,805(-7,882 to -1,728)] compared to conventional synthetic DMARDs for RA treatment. GRADE assessment indicated very low confidence in pooled cost-utility results and likely presence of risk of bias on overall ECOBIAS checklist in studies.Based on the available evidence during the study period, TNF-a-i is not a cost-effective option for treating RA compared to other DMARDs. However, high heterogeneity and low confidence in GRADE quality assessment preclude the results from being generalizable.