POS1416 THE IMPACT OF NON-PERSISTENCE ON RESOURCE UTILIZATION COSTS IN IMMUNE-MEDIATED RHEUMATIC DISEASES

Autor: S. Grau, Carolina Pérez-García, M. E. Navarrete-Rouco, E. Garcia-Alzorriz Morral, O. Ferrández-Quirante, Jordi Monfort, N. Carballo, X. Duran, F. Cots
Rok vydání: 2021
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 80:991.2-992
ISSN: 1468-2060
0003-4967
Popis: Background:Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are chronic progressive immune-mediated rheumatic diseases (IMRD) that can cause a progressive disability and joint deformation and thus can impact in healthcare resource utilization (HCRU) and costs.Objectives:To describe the HCRU and treatment costs in IMRD patients initiating subcutaneous tumour necrosis factor-alpha inhibitors (SC-TNFi) therapy, based on treatment persistence.Methods:Retrospective cohort study including all naïve patients initiating SC-TNFi therapy for IMRD from 2015-2018 in a tertiary university hospital.Patients were divided into two cohorts: persistent and non-persistent. Treatment persistence was estimated as the duration of time from SC-TNFi therapy initiation to discontinuation during one year of follow-up.SC-TNFi therapy and HCRU costs (outpatient care, rheumatology specialized outpatient care, inpatient care, emergency care, laboratory testing and other non- biological therapies) were calculated one year before and after initiation of SC-TNFi and compared between persistence and non-persistence groups.Results:110 patients were identified.Baseline characteristics: Non-persistent cohort (n=25) versus Persistent cohort (n=85): median age 48.6(12.7) vs 47.3(15.4) (p=0.692). Female (n=12;48%) vs (n=49;57.6%) (p=0.493). Race: Caucasian (n=22;88%), Asiatic (n=3;12%), Other (n=0;0%) vs Caucasian (n=75;88.2%), Asiatic (n=5;5.9%), Other (n=5;5.9%) (p=0.351).IMRD: RA (n=14;56%),PsA (n=2;8%), AS (n=4;16%), other spondyloarthropathy (n=5;20%) vs RA (n=34;40%),PsA (n=11;12.9%), AS (n=24;28.3%), other spondyloarthropathy (n=16;18.8%) (p=0.470). SC-TNFi therapy: adalimumab (n=4;16%), etanercept commercial (n=4;16%), etanercept biosimilar1 (n=5;20%), etanercept biosimilar2 (n=5;20%), golimumab (n=5;20%), certolizumab (n=2;8%) vs adalimumab (n=22;25.9%), etanercept commercial (n=11;12.9%), etanercept biosimilar1 (n=7;8.3%), etanercept biosimilar2 (n=10;11.8%), golimumab (n=24;28.2%), certolizumab (n=11;12.9%) (p=0.398).Overall cost of SC-TNFi treatment: Non-persistent 11218.81€ (6444.32), persistent 10470.19€ (3465.48); p= 0.658.Table 1.HCRU costsNon-persistent(n=25)Persistent(n=85)Total(n=110)PHCRU costs 12 months prior to SC-TNFi initiation,€(SD)Outpatient care243.48(828.86)87.17(293.61)122.70(471.20)0.204Rheumatology outpatient care216.39(169.88)174.79(101.06)184.24(120.55)0.224Inpatient care500.41(1542.93)170.34(846.47)245.36(1046.74)0.571Emergency care37.77(66.00)39.30(83.16)38.95(79.31) 0.850Laboratory testing376.12(195.59)388.20(207.07)385.46(203.70)0.458Other non-biological therapies10.77(39.83)36.79(250.55)30.88(221.01) 0.803Total1384.94(1816.17)896.60(1247.60)1007.59(1402.87)0.299HCRU costs 12 months post SC-TNFi initiation,€(SD)Outpatient care106.11 (172.85)76.67 (112.90)83.36 (128.67) 0.682Rheumatology outpatient care327.29(170.10)195.58(100.05)225.52(130.99)Inpatient care89.35(446.77)80.86(466.54)82.79(460.11) 0.969Emergency care89.14(171.89)36.06(106.23)48.12(125.31) 0.198Laboratory testing182.14(128.62)146.86(141.48)154.88(138.89) 0.061Other non-biological therapies3859.80(4043.86)25.89(116.05)897.24(2493.21)Total4653.84(4269.61)561.93(682.14)1491.91(2709.23)Conclusion:- Non-persistence was observed in less than a quarter of the patients.- No differences in the costs of SC-TNFi treatment were observed between the persistent and non-persistent groups, leading us to believe that persistence may not be associated with SC-TNFi costs offsets for patients with IMRD.- During the period post SC-TNFi initiation, the costs of rheumatologic outpatient care and treatment with other non-biological therapies as well as total costs were statistically significantly lower in the persistent cohort. These results suggest that persistence may be associated with HCRU cost savings for IMRD patients.Disclosure of Interests:None declared
Databáze: OpenAIRE
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